Percutaneous fetal endoscopic third ventriculostomy for severe isolated cerebral ventriculomegaly.

OBJECTIVE: To demonstrate the feasibility and preliminary results of percutaneous fetal endoscopic third ventriculostomy (ETV) in human fetuses (pfETV) with isolated progressive and/or severe bilateral cerebral ventriculomegaly (IPSBV). METHODS: The initial results of pfETV for IPSBV were described. Perioperative, perinatal and postnatal variables were described. The Ages and Stages Questionnaire (ASQ-3), 3rd edition (ASQ-3) was used for follow-up of all infants. RESULTS: Successful pfETV was performed in 10/11 (91%) fetuses, at a median gestational age (GA) of 28.7 weeks (25.3-30.7). There were no perioperative complications. After pfETV, 70% (7/10) of the fetuses had a decreased or stabilized lateral ventricle atria|lateral ventricle's atria. The median GA at delivery was 38.2 weeks (35.9-39.3). There were no perinatal complications. The postnatal ventriculoperitoneal shunt rate was 80% (8/10). Among neonates/infants who had prenatal stabilization or a decrease in the LVAs, 4 (4/7: 57.1%) had abnormal scores on the ASQ-3. Among neonates/infants that experienced prenatal increases in the LVAs, all of them (3/3: 100%) had abnormal scores on the ASQ-3. CONCLUSION: Percutaneous ETV is feasible in human fetuses with progressive and/or severe cerebral ventriculomegaly and seems to be a safe procedure for both the mother and the fetus.

Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on children's ability to walk.

OBJECTIVE: To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the ability of children to walk. METHODS: Children who underwent in utero repair of OSD and had formal neurological assessment after 2.5 years of age were compared regarding their ability to walk in relation to pre-surgical predictors. RESULTS: Sixty-nine children fulfilled the inclusion criteria. Among them, 63.7% (44/69) were able to walk with or without orthesis. Fetal OSD correction performed earlier in gestation (from 19.7 to 26.9 weeks) was associated with a higher probability of walking with or without orthesis (p = 0.033). The median GA at delivery was 35.3 weeks. Multivariate binary logistic regression showed that the upper anatomical level of the OSD ( L5) (p < 0.004; OR: 10.31 [95% CI: 2.07-51.28]) and GA at the time of fetal surgery (p = 0.026; OR = 0.68 [95% CI: 0.48-0.95]) were independent predictors of the postnatal ability to walk with or without orthesis. CONCLUSION: Fetuses with OSD who were operated on earlier in pregnancy (range: 19.7-26.9 weeks), were more likely to walk with or without orthesis.

Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on the perinatal outcomes and postnatal shunt rates.

OBJECTIVE: To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the perinatal outcomes and the infants' ventriculoperitoneal shunt rates. METHODS: Retrospective study of cases of fetal OSD correction performed from 2014 and 2019. RESULTS: One hundred and ninety women underwent fetal surgery for OSD through a mini-hysterotomy, and 176 (176/190:92.6%) have since delivered. Fetal OSD correction performed earlier in the gestational period, ranging from 19.7 to 26.9 weeks, was associated with lower rates of postnatal ventriculoperitoneal shunting (P: .049). Earlier fetal surgeries were associated with shorter surgical times (P: .01), smaller hysterotomy lengths (P < .001), higher frequencies of hindbrain herniation reversal (P: .003), and longer latencies from surgery to delivery (P < .001). Median GA at delivery was 35.3 weeks. Multivariate binary logistic regression showed that both fetal lateral ventricle-to-hemisphere ratio (%; P < .001; OR: 1.14 [95% CI: 1.09-1.21]) and GA at the time of fetal surgery (P: .016; OR: 1.37 [95% CI: 1.07-1.77]) were independent predictors of postnatal ventriculoperitoneal shunting. CONCLUSION: Fetuses with OSD who were operated on earlier in the gestational interval, which ranged from 19.7 to 26.9 weeks, were less prone to receiving postnatal ventriculoperitoneal shunts.

Etnografia das práticas psis no Facebook / Etnografía de las prácticas psicológicas en el Facebook / Ethnography of the psychological practices on Facebook

Resumo: A intimidade no contemporâneo se faz visível em diferentes dispositivos midiáticos. Os psicólogos clínicos acompanharam essa transformação, deixaram o espaço preservado de seus consultórios ocupando as mídias. Outras versões da psicologia foram inventadas, uma psicologia dita comprometida com o bem-estar coletivo que o proporciona através da divulgação de seu saber e de orientações. Observamos a criação de perfis profissionais de psicólogos que divulgam saberes e práticas psicológicas e respondem aos usuários da rede sobre questões relacionais, emocionais ou comportamentais. Neste recorte estabelecemos o problema proposto: que versões da psicologia são produzida nas páginas de psicólogos no Facebook? A pesquisa revelou versões de Psicologias que ensinam formas de viver apontando um voltar-se para si mesmo como caminho para felicidade.

Resumen: La intimidad en la contemporaneidad se hace visible en diferentes medios. Los psicólogos clínicos acompañaron esta transformación, dejaron el espacio preservado de sus consultorios, ocupando las redes sociales. Es decir, otras versiones de la psicología se han inventado, una psicología comprometida con el bienestar colectivo que se proporciona a través de la divulgación de su saber y de orientaciones. Observamos la creación de perfiles profesionales de psicólogos que divulgan saberes y prácticas psicológicas y contestan a los usuarios de la red acerca de cuestiones relacionales, emocionales o comportamentales. En este artículo establecemos el problema propuesto. ¿Qué versiones de psicología se producen en las páginas de psicólogos en el Facebook? La investigación reveló una versión de Psicología que enseña formas de vivir apuntando a un volverse a sí mismo como el camino para la felicidad.

Abstract: The intimacy in the contemporary makes itself visible through different media devices. Clinical psychologists followed this transformation, let the preserved space in their practices occupying different media. Other versions of psychology were invented, a psychology told to be committed to the collective well-being and that offers it through the disclosure of their knowledge and orientations. We observe the creation of psychologists' professional profiles that share their knowledge and psychological practices and answer to the net users about relationship, emotional or behavioral topics. On this framing we established the following problem: which psychology versions are produced on psychologists' pages on Facebook? The research revealed a psychology version that teaches ways to live life aiming a focus on itself as a way to achieve happiness.

Avaliação da qualidade da água do Ribeirão Samambaia (São Pedro, São Paulo, Brasil) através de parâmetros físicos e químicos, índice de estado trófico e teste de toxicidade com Daphnia magna / Water quality assessment in Samambaia Creek (São Pedro, São Paulo, Brazil) through physical chemical parameters, trophic state index and toxicity test with Daphnia magna

RESUMO O objetivo deste trabalho foi avaliar a qualidade da água do Ribeirão Samambaia (São Pedro, São Paulo, Brasil) utilizando parâmetros físicos e químicos, índice de estado trófico (IET) e ensaio ecotoxicológico com Daphnia magna. De janeiro a dezembro de 2011, amostras de água foram coletas mensalmente à montante e à jusante de São Pedro e dentro da cidade, e expostas a D. magna em laboratório durante 48 horas para avaliar efeitos sobre sua mobilidade. Condutividade, fenóis, oxigênio dissolvido, demanda bioquímica de oxigênio, surfactantes, pH e IET foram mensurados. Valores dos cinco primeiros parâmetros demonstraram baixa qualidade da água à jusante da cidade. Valores de clorofila-a estiveram dentro do permitido pela legislação ambiental brasileira e, dessa forma, o IET das águas do Ribeirão Samambaia foi classificado como ultraoligotrófico para a maioria dos locais e meses amostrados. Amostras de água coletadas de janeiro a abril à jusante de São Pedro foram tóxicas para D. magna. De acordo com as características físicas e químicas e o ensaio ecotoxicológico, conclui-se que o Ribeirão Samambaia possui baixa qualidade da água após a cidade de São Pedro.

ABSTRACT The goal of this study was to evaluate the water quality of Samambaia Creek (São Pedro, São Paulo, Brazil) through physical chemical parameters, trophic state index (TSI) and ecotoxicological assay with Daphnia magna. From January to December 2011 water samples were monthly collected from upstream, downstream and inside the São Pedro city, and exposed to D. magna in laboratory for 48 hours to evaluate mobility effects. Conductivity, phenols, dissolved oxygen, biochemical oxygen demand, surfactants, pH, and TSI were measured. Values of the first five parameters showed low water quality downstream of the city. Chlorophyll a values ​​were within the range permitted by the Brazilian environmental legislation and thus the TSI in Samambaia Creek was classified as ultra-oligotrophic for most sites and months. Water samples collected from January to April downstream of São Pedro were toxic to D. magna. The physical chemical analysis and the toxicity test indicate low quality of water from Samambaia Creek downstream the city of São Pedro.

Fetal Myelomeningocele Repair through a Mini-Hysterotomy.

OBJECTIVE: To present the feasibility of fetal myelomeningocele (MMC) repair through a mini-hysterotomy and to describe the perinatal results from our initial experience. METHODS: A descriptive study of cases of fetal MMC correction via mini-hysterotomy performed between 2014 and 2016. RESULTS: Forty-five women underwent fetal surgery and 87% (39/45) delivered. A complete multilayer correction of the MMC was possible in all cases. There were no maternal, fetal or neonatal deaths. No maternal or fetal complications occurred from fetal MMC correction until maternal hospital discharge. The average gestational age (GA) at surgery was 24.5 weeks (standard deviation, SD: 1.7; range: 20.7-26.9). The median hysterotomy length was 3.05 cm (SD: 0.39; range: 2.50-3.50). One patient (1/39; 2.6%) experienced chorioamniotic separation. Nine patients (9/39; 23.1%) had premature preterm rupture of membranes at a median GA of 34.1 weeks (range: 31.1-36.0). The average GA at delivery was 35.3 weeks (SD: 2.2; range: 27.9-39.1). Ninety-five percent (37/39) of our patients had an intact hysterotomy site at delivery. Ventriculoperitoneal shunt placement was necessary for 7.7% (3/39) of the neonates. CONCLUSION: Fetal MMC repair is feasible through a mini-hysterotomy. This approach appears to be associated with reduced risks of very preterm delivery and maternal, fetal and neonatal complications.

Study of spatial and temporal distribution of antimicrobial in water and sediments from caging fish farms by on-line SPE-LC-MS/MS.

An on-line solid phase extraction liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS) method for the determination of 12 antimicrobials in sediment and surface water was developed and validated. Furthermore, the spatial and temporal antimicrobials distributions in the sediment and in the water of four fish farms located in the hydroelectric dam of Ilha Solteira Reservoir in Brazil were investigated over four seasons in three sampling sites: at the fish cages, 100 and 1,000 m downstream far from the cages. The method was performed using an Agilent Zorbax 80 SB-C8 column (9.4 × 15 mm, 5 µm) as the loading column, and the Agilent Zorbax Eclipse Plus C18 column (3.0 × 100 mm, 3.5 µm) as a separation column within a run time of 13 min. The limits of quantification were less than 9 ng·L(-1) for the antibiotics in water and 16 µg·kg(-1) in sediment; the recovery ranged from 80 to 119%, with a variation coefficient less than 11%, and the repeatability was lower than 15%. Oxytetracycline was found in the water in all sample seasons. However, florfenicol was identified in April and October 2013 and January 2014, and tetracycline was present in July 2013. Regarding the sediment, oxytetracycline and tetracycline were found in all sampling periods, but chlortetracycline was only identified in January 2014. The spatial distribution of antimicrobials showed that the main pollution source came from the fish farms. This study demonstrated that the proposed method is reliable for the monitoring of antimicrobials in water and sediments and it showed contamination in both matrices from Ilha Solteira Reservoir.

Atrazine levels in the Jaboticabal water stream (São Paulo State, Brazil) and its toxicological effects on the pacu fish Piaractus mesopotamicus.

The aim of this study was to determine the environmental concentration of atrazine (ATZ) in five streams located in the north of São Paulo state (Brazil) and evaluate its toxicological impact on young specimens of the pacu fish Piaractus mesopotamicus. Samples of water were collected on three occasions between 2010 and 2011, corresponding to periods signifying the beginning, middle, and end of rain season. ATZ levels were estimated by a high-performance liquid chromatography coupled with a mass spectrometry (HPLC-MS/MS) triple quadrupole. Later, the quotient of environmental risk (QR) was determined based on the medium lethal concentration (LC50 48 h), non-observable effect concentration (NOEC), and the estimated environmental concentration (EEC) of ATZ detected in the environment. Histological changes in gills and liver were also studied, along with the brain activity of the enzyme acetylcholinesterase (AChE). The highest concentration of ATZ measured was 10.4 µg L(-1). The ATZ LC50 (48 h) for young P. mesopotamicus was 24.46 mg L(-1) and the QR was classified as "safe". Although the QR indicated that ATZ could be safe for the tested species, it caused many histological alterations in the liver and gills of the exposed specimens, and an increase in the AChE levels.

Dissolved heavy metal determination and ecotoxicological assessment: a case study of the corumbataí river (são paulo, Brazil).

The aim of this one-year study (August 2009 to July 2010) was to evaluate the Corumbataí River water polluted by anthropogenic sources and see how it affects the reproduction of the microcrustacean Ceriodaphnia dubia (Richard, 1984) in laboratory conditions over seven days of exposure to water samples collected monthly at six different locations. We determined the concentrations of zinc (Zn), copper (Cu), nickel (Ni), lead (Pb), and cadmium (Cd), as well as physicochemical parameters such as dissolved oxygen, conductivity, water temperature, and pH. Dissolved oxygen and conductivity demonstrated anthropogenic influence, as dissolved oxygen concentration decreased and conductivity increased from the upstream to the downstream stretch of the river. The effects on C. dubia were observed in the months with high precipitation, but the toxicity cannot be associated with any particular contaminant. Heavy metal levels kept well below the limit values. Zn and Pb had the highest concentrations in the water during the sampling period, probably due to the industrial and agricultural influence. However, these levels do not seem to be associated with precipitation, which suggests that their primary source was industry. Physicochemical parameters, the ecotoxicological assay, and determination of heavy metals proved to be efficient tools to evaluate aquatic environments.

Feasibility and reproducibility of diffusion-weighted magnetic resonance imaging of the fetal brain in twin-twin transfusion syndrome.

OBJECTIVE: The aim of this study is to test the feasibility and reproducibility of diffusion-weighted magnetic resonance imaging (DW-MRI) evaluations of the fetal brains in cases of twin-twin transfusion syndrome (TTTS). METHOD: From May 2011 to June 2012, 24 patients with severe TTTS underwent MRI scans for evaluation of the fetal brains. Datasets were analyzed offline on axial DW images and apparent diffusion coefficient (ADC) maps by two radiologists. The subjective evaluation was described as the absence or presence of water diffusion restriction. The objective evaluation was performed by the placement of 20-mm(2) circular regions of interest on the DW image and ADC maps. Subjective interobserver agreement was assessed by the kappa correlation coefficient. Objective intraobserver and interobserver agreements were assessed by proportionate Bland-Altman tests. RESULTS: Seventy-four DW-MRI scans were performed. Sixty of them (81.1%) were considered to be of good quality. Agreement between the radiologists was 100% for the absence or presence of diffusion restriction of water. For both intraobserver and interobserver agreement of ADC measurements, proportionate Bland-Altman tests showed average percentage differences of less than 1.5% and 95% CI of less than 18% for all sites evaluated. CONCLUSION: Our data demonstrate that DW-MRI evaluation of the fetal brain in TTTS is feasible and reproducible.

Water quality assessment in piracicamirim creek upstream and downstream a sugar and ethanol industry through toxicity tests with cladocerans

An environmental impact study was conducted to determine the Piracicamirim's creek water quality in order to assess the influence of effluents from a sugar industry in this water body. For this, toxicity tests were performed with a water sample upstream and downstream the industry using the microcrustaceans Daphnia magna, Ceriodaphnia dubia and Ceriodaphnia silvestrii as test organisms, as well as physical and chemical analysis of water. Results showed that physical and chemical parameters did not change during the sampling period, except for the dissolved oxygen. No toxicity was observed for D. magna and reproduction of C. dubia and C. silvestrii in both sampling points. Thus, the industry was not negatively impacting the quality of this water body.

Toxicidade aguda e crônica do extrato de NIM (Azadirachta indica) para Ceriodaphnia dubia / Acute and chronic toxicity of the extract of Nee (Azadirachta indica) to Ceriodaphnia dubia

A preocupação com as questões ambientais tem levado ao crescimento de pesquisas relacionadas aos compostos com potencial no controle de pragas na agricultura, direcionando alternativas que minimizem os impactos ao ambiente. Nesse sentido acredita-se que a utilização de produtos proveniente de plantas possa representar opção eficaz para o controle de pragas com menor risco ambiental.Objetivou-se com este trabalho avaliar a toxicidade aguda e crônica de uma formulação comercial de nim para Ceriodaphnia dubia. A CE50 (48h) determinada foi de 0,032 mL·L-1, e os valores de CENO, CEO e VC foram respectivamente em mL·L-1:0,004; 0,008 e 0,006. Os testes de toxicidade mostraram efeitos do produto tanto na mobilidade como na reprodução de C. dubia.