Occurrence of halogenated natural products in highly consumed fish from polluted and unpolluted tropical bays in SE Brazil.

Natural compounds from the metabolism of marine organisms have been detected at high concentrations in environmental samples which are not the producers of these compounds. These natural substances are known as halogenated natural products (HNPs). HNPs are possibly toxic halogenated compounds analogous to POPs that may bioaccumulate and biomagnify along the food web and pose a further risk to human and environmental health. The present study analyzed the occurrence of HNPs in the edible muscle of the three most consumed commercial fish species in the state of Rio de Janeiro: sardine (Sardinella brasiliensis), whitemouth croaker (Micropogonias furnieri) and mullet (Mugil liza) from the highly polluted Guanabara Bay (GB) and the less polluted Ilha Grande Bay (IGB). The analytical steps included Soxhlet extraction, clean-up step and injection in a gas chromatography system coupled to a mass spectrometer operated in the electron-capture negative ion mode (GC/ECNI-MS). The compounds 2,4,6-TBP, 2,4,6-TBA, MHC-1, Q1, 6-MeO-BDE 47 and 2'-MeO-BDE 68 were found in the analyzed fish from both studied areas. Q1, 6-MeO-BDE 47 and 2'-MeO-BDE 68 showed the highest concentrations in samples. Q1 concentrations in the sardines from IGB were higher than the sardines from GB (p < 0.05) and higher than the other IGB species (p < 0.05). The differences found among the species may be related to their characteristic habitat and diet. It is noteworthy that most of these compounds do not have any toxicological reference value. Moreover, the HNPs are being detected in species of low trophic level and since this study has worked only with commercial species, these fish may be considered as a source for human exposure to these natural compounds.

Prediction of intake in growing dairy heifers under tropical conditions.

A meta-analysis was conducted to develop models of the prediction of dry matter intake (DMI) in growing dairy heifers [postweaning to 390 kg of body weight (BW)] under tropical conditions. The adequacy of the models was assessed in a comparison with the 4 US models currently used to predict DMI [Quigley; National Research Council; and 2 Hoffman models]. The data set was created using 95 treatment means from 28 studies published in journals. The data set (studies) was randomly divided into 2 data subsets for the statistical analyses. The first data subset was used to develop the prediction equations for DMI (17 studies; 58 treatment means), and the second data subset was used to assess the adequacy of the predictive models (11 studies; 37 treatment means). The models were developed using nonlinear and linear mixed analyses. Breed (Bos taurus vs. Bos taurus × Bos indicus), BW (240.2±62.2 kg), and average daily gain (ADG, 0.83±0.28 kg/d) were the independent variables. No significant effects of the breed or the interactions between the breed and metabolic BW (BW(0.75)) or breed and ADG were detected. Thus, nonlinear [DMI=0.1175 × BW(0.75) - 3.4984 × e((-2.4690 × ADG))] and linear models [DMI=8.7147 - 0.2402 × BW(0.75) + 0.0027 × (BW(0.75))(2) + 3.6050 × ADG - 1.4168 × ADG(2)] were proposed for both breeds. The nonlinear model explained 81% of the variation in the DMI, over-predicted the DMI by 0.21 kg/d and predicted the DMI with a higher accuracy and precision than the linear model [root mean square error of prediction (RMSEP)=8.82 vs. 10.71% of the observed DMI, respectively]. The Quigley model explained only 54% of the variation in the DMI and was the fourth most accurate and precise model (RMSEP=11.21% of the observed DMI). The National Research Council model explained 69% of the variation in the DMI but under-predicted the DMI by 0.53 kg/d, with an RMSEP of 12.72% of the observed DMI and presence of systematic constant bias. The Hoffman exponential model I (BW as the input) adequately predicted the DMI with an accuracy that was similar to the proposed nonlinear model. The equation of the Hoffman exponential model I explained 75% of the variation in the DMI and over-predicted the DMI by 0.07 kg/d, which was the second most accurate and precise equation (RMSEP=9.35% of the observed DMI). However, the Hoffman exponential model II (BW and diet NDF as the inputs) did not adequately predict the DMI, because it explained only 54% of the variation in the DMI, under-predicted the DMI by 0.72 kg/d, and had a high RMSEP (17.96% of the observed DMI). The use of nonlinear models increase the accuracy and the precision of the prediction of DMI compared with the linear models. Only the models proposed in the present study, the Hoffman exponential model I (BW as the input), and the Quigley model were adequate for the prediction of the DMI of growing dairy heifers under tropical conditions.

A pilot study of topiramate in children with Lennox-Gastaut syndrome.

We conducted an open, add-on study with topiramate (TPM) as adjunctive therapy in Lennox-Gastaut syndrome (LGS), to assess the long-term efficacy and safety and to evaluate quality of life (QL) measurements in the chronic use of TPM. We studied 19 patients (11 male; age ranging from 4 to 14 years) with uncontrolled seizures receiving 2-3 anti-epileptic drugs. Patients were followed up to 36 months of treatment. A questionnaire was used to query parents about QL. Seven patients completed the study at 36 months and seizure frequency was reduced > or = 75% in 4, and < 50% in 3 patients. Two children became seizure free for more than 24 months. Most side effects were CNS related, with the most frequent being somnolence and anorexia. These were generally transient. One patient dropped-out due to powder in the urine. None of the patients required hospitalization. At 36 months, patients' alertness (2/7), interaction with environment (5/7), ability to perform daily activities (5/7), and verbal performance (6/7) improved on TPM. We conclude that TPM may be useful as adjunctive therapy in the treatment of LGS. The efficacy of TPM was maintained in long-term treatment in more than 40% of patients, long term safety was confirmed and QL improved on TPM.

A pilot study of topiramate in children with Lennox-Gastaut syndrome

We conducted an open, add-on study with topiramate (TPM) as adjunctive therapy in Lennox-Gastaut syndrome (LGS), to assess the long-term efficacy and safety and to evaluate quality of life (QL) measurements in the chronic use of TPM. We studied 19 patients (11 male; age ranging from 4 to 14 years) with uncontrolled seizures receiving 2-3 anti- epileptic drugs. Patients were followed up to 36 months of treatment. A questionnaire was used to query parents about QL. Seven patients completed the study at 36 months and seizure frequency was reduced = 75 per cent in 4, and < 50 per cent in patients. Two children became seizure free for more than 24 months. Most side effects were CNS related, with the most frequent being somnolence and anorexia. These were generally transient. One patient dropped-out due to powder in the urine. None of the patients required hospitalization. At 36 months, patients' alertness (2/7), interaction with environment (5/7), ability to perform daily activities (5/7), and verbal performance (6/7) improved on TPM. We conclude that TPM may be useful as adjunctive therapy in the treatment of LGS. The efficacy of TPM was maintained in long-term treatment in more than 40 per cent of patients, long term safety was confirmed and QL improve on TPM.

[Quality of life of patients after epilepsy surgery]. / Qualidade de vida de pacientes submetidos a cirurgia de epilepsia.

Drug resistant epilepsy impairs patients' quality of life making social interaction more difficult. Surgical treatment is an option for seizure control in medically refractory patients. We evaluated pre-operative and post-operative quality of life using a standardized questionnaire based on the QOLIE-10. The questionnaire included ten questions dealing with psychosocial and drug's side effects and was applied before surgery and eight months post-operatively. The studied sample comprised twelve consecutive adult patients with epilepsy treated surgically who were seizure free. Differences were found between the pre-operative and post-operative periods in 70% of the questions, with a better post-operative profile. Successful epilepsy surgery has a great impact in the quality of life of these patients.

Secondary bilateral synchrony due to fronto-mesial lesions. An invasive recording study.

Frontal lobe epilepsies may present difficulties in focus localization in the pre-operative work-up for epilepsy surgery. This is specially true in patients with normal MRIs. We report on a 16 years-old girl that started with seizures by the age of 8 years. They were brief nocturnal episodes with automatisms such as bicycling and boxing. Seizure frequency ranged from 4-10 per night. Scalp EEG showed few right frontal convexity spiking and intense secondary bilateral synchrony (SBS). High resolution MRI directed to the frontal lobes was normal. Ictal SPECT suggested a right fronto-lateral focus. Ictal video-EEG showed no focal onset. She was submitted to invasive recordings after subdural plates implantation. Electrodes covered all the frontal convexity and mesial surface bilaterally. Ictal recordings disclosed stereotyped seizures starting from the right mesial frontal. Using a high-resolution tool to measure intra and interhemispheric latencies, the timing and direction of seizure spread from the right fronto-mesial region were studied. Motor strip mapping was performed by means of electrical stimulation. She was submitted to a right frontal lobe resection, 1.5 cm ahead of the motor strip and has been seizure free since surgery (8 months). Pathological examination found a 4 mm area of cortical dysplasia. Invasive studies are needed to allow adequate localization in patients with non-localizatory non-invasive work-up and may lead to excellent results in relation to seizures after surgery.

Mamaplastia redutora pela tecnica de pediculo dermogorduroso da base inferior. / Breast reduction by the inferior based dermofat pedicle technique

A reducao mamaria utilizando-se de retalho pediculado de base inferior para transposicao de areola e mamilo e discutida neste artigo. Os autores defendem o procedimento para mamas gigantes e descrevem a tecnica em detalhe