Spatial dependency of arsenic, antimony, boron and other trace elements in the shallow groundwater systems of the Lower Katari Basin, Bolivian Altiplano.

Spatial patterns, cluster or dispersion trends are statistically different from random patterns of trace elements (TEs), which are essential to recognize, e.g., how they are distributed and change their behavior in different environmental processes and/or in the polluted/contaminated areas caused by urban and industrial pollutant located in upstream basins and/or by different natural geological conditions. The present study focused on a statistical approach to obtain the spatial variability of TEs (As, B and Sb) in shallow groundwater (GW) in a high-altitude arid region (Lower Katari Basin, Bolivian Altiplano), using multivariate analysis (PCA and HCA), geochemical modeling (PHREEQC, MINTEQ) and spatial analyses (Moran's I and LISA), considering the community supply wells. The results indicate that despite of the outliers there is a good autocorrelation in all cases, since Moran's I values are positive. The global spatial dependence analysis indicated a positive and statistically significant spatial autocorrelation (SA) for all cases and TEs are not randomly distributed at 99% confidence level. The results of hydrochemical modeling suggested the precipitation and stability of Fe (III) phases such as goethite. The re-adsorption of As and Sb on the mineral surface in the aquifer could be limiting the concentrations of both metalloids in southern regions. Spatial autocorrelation was positive (High-High) in northwestern (arsenic), southeastern (boron) and northeastern (antimony) region. The results reflected that the As and Sb are the main pollutants linked to the natural geological conditions, but B is a main pollutant due to the anthropogenic activities. Furthermore, >50% shallow groundwater exceeded the WHO limit and NB-512 guideline values for Sb (87%), B (56%) and As (50%); therefore the spatial distribution and concentrations of these TEs in GW raise a significant concern about drinking water quality in the study area.

Contrasting controls on hydrogeochemistry of arsenic-enriched groundwater in the homologous tectonic settings of Andean and Himalayan basin aquifers, Latin America and South Asia.

High groundwater arsenic (As) across the globe has been one of the most well researched environmental concerns during the last two decades. Consequently, a large scientific knowledge-base has been developed on As distributions from local to global scales. However, differences in bulk sediment As concentrations cannot account for the As concentration variability in groundwater. Instead, in general, only aquifers in sedimentary basins adjacent to mountain chains (orogenic foreland basins) along continental convergent tectonic margins are found to be As-enriched. We illustrate this association by integrating observations from long-term studies of two of the largest orogenic systems (i.e., As sources) and the aquifers in their associated foreland basins (As sinks), which are located in opposite hemispheres and experience distinct differences in climate and land-use patterns. The Andean orogenic system of South America (AB), an active continental margin, is in principle a modern analogue of the Himalayan orogenic system associated with the Indus-Ganges-Brahmaputra river systems in South Asia (HB). In general, the differences in hydrogeochemistry between AB and HB groundwaters are conspicuous. Major-solute composition of the arid, oxic AB groundwater exhibits a mixed-ion hydrochemical facies dominated by Na-Ca-Cl-SO4-HCO3. Molar calculations and thermodynamic modeling show that although groundwater of AB is influenced by cation exchange, its hydrochemical evolution is predominated by feldspar dissolution and relationships with secondary clays. In contrast, humid, strongly reducing groundwater of HB is dominated by Ca-HCO3 facies, suggestive of calcite dissolution, along with some weathering of silicates (monosiallitization). This work demonstrates that although hydrogeochemical evolutionary trends may vary with local climate and lithology, the fundamental similarities in global tectonic settings can still lead to the elevated concentrations of groundwater As.

Metabolismo de la próstata y la progresión al Cáncer de Próstata / Metabolism of the prostate and progression to Prostate Cancer

El cáncer de próstata se caracteriza por una baja tasa de absorción de glucólisis y glucosa. En las células prostáticas, los ácidos grasos predominan sobre la glucosa en la obtención de energía. Los mecanismos genéticos y moleculares responsables y asociados específicamente con el desarrollo y la progresión de las células de próstata malignas son en gran parte no identificados. Junto con esto, se ignora el papel del metabolismo celular alterado como un factor esencial en la malignidad de la próstata; aunque las transformaciones del metabolismo están implicadas en prácticamente todas las células malignas. Las combinaciones genéticas / moleculares / metabólicas son necesarias para identificar eventos críticos en el proceso de malignidad de la próstata. Dichos estudios están comenzando a revelar una comprensión esencial del desarrollo y la progresión del cáncer de próstata. Conclusión: las células de la próstata se caracterizan por una absorción dominante de ácido graso sobre la glucosa, lo que sugiere que el desarrollo futuro de nuevos enfoques diagnósticos y terapéuticos en el cáncer de próstata debería centrarse en el sustrato de ácido graso.

Prostate cancer is characterized by a low absorption rate of glycolysis and glucose. In prostate cells, fatty acids predominate over glucose in obtaining energy. The genetic and molecular mechanisms responsible and specifically associated with the development and progression of malignant prostate cells are largely unidentified. Along with this, the role of altered cellular metabolism as an essential factor in the malignancy of the prostate is ignored; although the transformations of metabolism are involved in practically all malignant cells. Genetic / molecular / metabolic combinations are necessary to identify critical events in the process of malignancy of the prostate. These studies are beginning to reveal an essential understanding of the development and progression of prostate cancer. Conclusion: prostate cells are characterized by a dominant absorption of fatty acid on glucose, which suggests that the future development of new diagnostic and therapeutic approaches in prostate cancer should focus on the fatty acid substrate.

Aplicación de la Tomografía por emisión de positrones en el cáncer de próstata marcado con 68Ga-PSMA: Revisión y actualidad / Application of positron emission tomography in prostate cancer marked with 68Ga-PSMA: Review and update

Una de las características de cáncer de próstata es su baja afinidad a la absorción de glucólisis y glucosa. Esto se traduce la baja afinidad del 18F-FDG para la detección de los tumores de próstata por el PET/ CT. El antígeno prostático específico de membrana (PSMA) es una proteína transmembrana presente en todos los tejidos prostáticos. El incremento de la expresión de PSMA está presente en varios tumores, aunque su concentración es más elevada en el cáncer de próstata. Casi todos los adenocarcinomas de próstata muestran expresión de PSMA en la mayoría de las lesiones, tanto primarias como metastásicas. La expresión del PSMA en cáncer de próstata es más elevada que en otros tipos de cáncer, donde se ha descrito la presencia de PSMA. Se ha demostrado que el incremento de este antígeno se presenta principalmente en casi todos los adenocarcinomas de próstata tanto primario como metastásico con diferentes grados de desdiferenciados. La tomografía por emisión de positrones/tomografía computarizada (PET/TC) es una técnica de imagen no invasiva, reconocida para el estudio de diversos tumores malignos. La PET/CT marcada con 68Ga-PSMA o 18F-PSMA proporciona imágenes metabólicas semicuantitativas de las concentraciones anormales de este antígeno permitiendo una valoración más precisa del cáncer de próstata. En esta revisión describiremos la importancia de 68Ga-PSMA PET/CT en la valoración del cáncer de próstata.

One of the characteristics of prostate cancer is its low affinity to the absorption of glycolysis and glucose. This translates the low affinity of 18F-FDG for the detection of prostate tumors by PET/CT. Prostate-specific membrane antigen (PSMA) is a transmembrane protein present in all prostate tissues. The increase in the expression of PSMA is present in several tumors, although its concentration is higher in prostate cancer. Almost all prostate adenocarcinomas show PSMA expression in most lesions, both primary and metastatic. The expression of PSMA in prostate cancer is higher than in other types of cancer, where the presence of PSMA has been described. It has been shown that the increase of this antigen occurs mainly in almost all prostate adenocarcinomas, both primary and metastatic with different degrees of dedifferentiated. Positron emission tomography / computed tomography (PET/CT) is a noninvasive imaging technique, recognized for the study of various malignancies. PET/CT labeled with 68Ga-PSMA or 18F-PSMA provides semi quantitative metabolic images of abnormal concentrations of this antigen allowing a more accurate assessment of prostate cancer. In this review we will describe the importance of 68Ga-PSMA PET/CT in the evaluation of prostate cancer.

Importancia del 18F-FDG PET/CT en patología no neoplásicas / Role of PET/CT with 18F-FDG in non-neoplastic pathology

En la actualidad el uso de las imágenes metabólicas en Medicina Nuclear con tecnología PET/ CT con diferentes radiotrazadores, en especial la 18F-FDG, se está extendiendo más allá del ámbito de la oncología, siendo las enfermedades inflamatorias e infecciosas de las que más interés están despertando. El PET/CT tiene la ventaja de poder detectar enfermedades incluso cuando no tienen una correlación en las imágenes morfológicas, permitiendo además localizar de manera precisa estas alteraciones. Entre las patologías más estudiadas se encuentran el estudio de fiebre de origen desconocido, enfermedades inflamatorias, enfermedades del tejido conectivo, vasculitis y también en el seguimiento y diagnóstico de algunas patologías infecciosas. En este artículo se hace una revisión de la aplicación y aporte de las imágenes PET/CT en diferentes patologías inflamatorias e infecciosas comparándolas con técnicas de imagen estructurales y de Medicina Nuclear convencional, haciendo énfasis en procesos inflamatorios e infecciosos articulares, prótesis en traumatología y prótesis vasculares complementando con casos clínicos.

At present, the use of metabolic images in Nuclear Medicine like PET/CT technology with different radiotracers, especially 18F-FDG, is extending beyond the field of oncology, with the inflammatory and infectious diseases being the most interesting. They are waking up PET/CT has the advantage of being able to detect diseases even when they do not have a correlation in morphological images, also locating these alterations accurately. Among the most studied pathologies are fever of unknown origin, inflammatory diseases, connective tissue diseases, vasculitis and also in the monitoring and diagnosis of some infectious diseases. In this article, a review of the application and contribution of PET/CT images in different inflammatory and infectious pathologies is made comparing them with structural imaging techniques and conventional Nuclear Medicine, speciallyd inflammatory and infectious joint processes, prostheses in traumatology and prostheses vascular and clinical cases.

Evaluación de la resistencia adhesiva entre el poste de fibra de vidrio y el muñón de resina utilizando diferentes tratamientos de superficie / Tensile Bond strength evaluation between glass fiber post and resin core using different surface treatments

La calidad de unión entre la superficie del poste de fibra de vidrio y el muñón es esencial para formar un solo núcleo. Si esta unión es afectada, ocasionaría una mala distribución de las fuerzas oclusales. Objetivos: Comparar la resistencia adhesiva entre el poste de fibra de vidrio y muñón de resina utilizando diferentes tratamientos de superficie. Material y métodos: La resistencia adhesiva se evaluó mediante el método de tracción. El diseño del estudio fue analítico, corte transversal y experimental in vitro.La población estuvo conformada por postes de fibra de vidrio estériles. El tamaño muestral fue de 24 postes; fueron divididos en cuatro grupos según el tratamiento de superficie: Grupo I, control negativo, con silano (60s); grupo II, control positivo, con peróxido de hidrógeno al 9%(30 volúmenes, 10min) seguido de lavado y silano (60s); grupo III y IV, grupos experimentales, con ácido fosfórico al 37%(15s) lavado y silano(60s) y con clorhexidina al 2%(60s) lavado y silano (60s).Luego, se elaboró un muñón para cada poste, la muestra fue colocada en la máquina de ensayo universal. La fuerza de tracción fue recopilada en Mpa. Resultados: Se determinó que el grupo silano obtuvo una media de 15,38; peróxido de hidrógeno al 9%+silano 20,28; ácido fosfórico al 37%+silano17,08; y clorhexidina al 2%+silano 13,44 Según la prueba de Shapiro Wilk, los cuatro grupos presentan distribución normal (p>0,05) y siguiendo la prueba de Barlett, se aprobó el supuesto de homogeneidad (p>0,05). Mediante la prueba multivariada de ANOVA; se determinó que existe diferencia estadística (p=0,0194), al menos, en un par de los cuatro grupos. Conclusiones: Existe diferencia estadísticamente significativa entre el grupo de peróxido de hidrógeno al 9%(30 volúmenes, 10 min)+silano(60s) y clorhexidina al 2%(60s)+silano(60s) (p=0,025), siendo el primero, la sustancia con mayor resistencia adhesiva.

The interface quality between the glass fiber post surface and core is essential to form a monoblock. If this interface is affected, a wrong distribution of occlusal forces could be caused. Objectives: To determine the bond strength between the glass fiber post and the resin core using different post surface treatments. Material and methods: The bond strength was evaluated by the traccional method. The study design was analytical, cross-sectional and experimental in vitro. The population were sterilized glass fiber posts. The sample size were 24 posts which were divided into four groups following the post surface treatment: Group I, negative control, with silane (60s); group II, positive control, with 9% hydrogen peroxide (30 volumes, 10min) followed by cleansing and silane (60s); groups III and IV, experimental groups, with phosphoric acid 37%(15s) followed by cleansing and silane(60s) and with clorhexidine 2%(60s) followed by cleansing and silane(60s). Therefore, a resin core was devised for each post, the sample was placed in the universal traction machine. The tensile force was collected in Mpa. Results: It was determined that the silane group obtained a mean of 15.38, 9% hydrogen peroxide+silane group 20.28, phosphoric acid 37%+silane group 17.08, and Clorhexidine 2% + silane group 13.44. According to the Shapiro-Wilk test, all four groups presented normal distribution (p>0.05) and following Barlett's test, the homogeneity of variances assumption was approved (p>0.05). Through the multifactor ANOVA test, it was determined that there is statistically significant difference (p=0.0194), at least in a couple of four groups. Conclusions: There is statistically significant difference between 9% hydrogen peroxide(30 volumes, 10min)+silane(60s) group and the Clorhexidine 2% (60s)+ silane(60s) group (p=0,025). Being the former glass surface treatment, the highest bond strength.

Enfermedades del trabajador en una empresa peruana en aplicación de la Ley de Seguridad y Salud en el Trabajo / Diseases of worker in a peruvian company law enforcement safety and health at work

Identificar las enfermedades más frecuentes, según área laboral. Material y Métodos: La investigación fue de tipo descriptivo, prospectivo, exploratorio y de corte transversal. Se realizó en una fábrica de Lima, que estaba en proceso de aplicación a la Ley de Seguridad y Salud en el Trabajo. Según los criterios de selección, ingresaron 121 trabajadores los cuales participaron del examen médico y se aplicó una ficha para datos médicos ocupacionales. Se realizó el análisis estadístico descriptivo (media, desviación estándar, frecuencias y respectivos IC 95%), se consideró un nivel de significancia (p<0,05). Se empleó el paquete estadístico SPSS y Microsoft Excel. Resultados: La población de estudio se agrupó en dos: obreros y administrativos. La edad media de la población fue 37,48 años y el sexo masculino representó el 83,5%. Las características patológicas más frecuentes fueron: Dislipidemia (Hipertrigliceridemia 66,9%, Hipercolesterolemia 64,5%), ametropía no corregida 37,2% e hipoacusia Leve 36,8% y sobrepeso 57%. Según el área laboral: el personal obrero, presentó mayor frecuencia de problemas auditivos, dislipidemia, sobrepeso e hipertensión arterial (HTA). El personal administrativo tuvo mayor afectación de dislipidemia, ametropía no corregida, obesidad grado I y sobrepeso.Conclusiones: Las enfermedades más frecuentes en las dos áreas ocupacionales según el grupo I: ametropía e hipoacusia; en el grupo II: la dislipidemia y el sobrepeso...

To identify the most common diseases, according the workplace. Material and Methods: The research was descriptive, prospective, exploratory and cross-sectional. It was made at a factory in Lima, which was in the process of application to the law Safety and Health at Work. According to the selection criteria, 121 workers were admitted, which took part of the medical examination, and a file card for medical occupational data was applied. The descriptive statistical analysis (mean, standard deviation, and respective frequencies of 95 %) was performed and a level of significance (p<0.05). The statistical package SPSS and Microsoft Excel were used. Results: The population of study was divided into two occupational areas: workers and administrative staff. The average age was 37.48 years and males represented 83.5%. The most frequent pathological characteristics were: Dyslipidemia (66.9% Hypertriglyceridemia, Hypercholesterolemia 64.5%), 37.2% uncorrected refractive error, 36.8% mild hearing loss and 57% overweight. According to the work area: manual workers showed a higher frequency of hearing problems, dyslipidemia, obesity and high blood pressure (HTA). The administrative staff had greater effects of dyslipidemia, uncorrected refractive error, Grade -I obesity and overweight. Conclusions: The most frequent occupational diseases in the two areas according to the group I: refractive errors and hearing loss. In group II: dyslipidemia and overweight...

A intersetorialidade nas políticas públicas para o envelhecimento no Brasil / The intersectoral public policies for aging in Brazil

Este artigo objetiva mostrar a necessidade de políticas intersetoriais no que concernem as políticas para a população idosa no Brasil. Por meio da pesquisa bibliográfica e documental, relacionaram-se ações conjuntas entre diferentes secretarias e/ou órgãos na implementação e condução das políticas para a população idosa no Brasil.(AU)

This paper aims to show the need for intersectoral policies that concern the policies for the elderly in Brazil. Through bibliographical and documentary research was related to joint actions between different departments and / or agencies in the implementation and conduct of policies for the elderly population in Brazil.(AU)

A intersetorialidade nas políticas públicas para o envelhecimento no Brasil / The intersectoral public policies for aging in Brazil

Este artigo objetiva mostrar a necessidade de políticas intersetoriais no que concernem as políticas para a população idosa no Brasil. Por meio da pesquisa bibliográfica e documental, relacionaram-se ações conjuntas entre diferentes secretarias e/ou órgãos na implementação e condução das políticas para a população idosa no Brasil.

This paper aims to show the need for intersectoral policies that concern the policies for the elderly in Brazil. Through bibliographical and documentary research was related to joint actions between different departments and / or agencies in the implementation and conduct of policies for the elderly population in Brazil.

Fractionation of heavy metals and assessment of contamination of the sediments of Lake Titicaca.

Chemical weathering is one of the major geochemical processes that control the mobilization of heavy metals. The present study provides the first report on heavy metal fractionation in sediments (8-156 m) of Lake Titicaca (3,820 m a.s.l.), which is shared by the Republic of Peru and the Plurinational State of Bolivia. Both contents of total Cu, Fe, Ni, Co, Mn, Cd, Pb, and Zn and also the fractionation of these heavy metals associated with four different fractions have been determined following the BCR scheme. The principal component analysis suggests that Co, Ni, and Cd can be attributed to natural sources related to the mineralized geological formations. Moreover, the sources of Cu, Fe, and Mn are effluents and wastes generated from mining activities, while Pb and Zn also suggest that their common source is associated to mining activities. According to the Risk Assessment Code, there is a moderate to high risk related to Zn, Pb, Cd, Mn, Co, and Ni mobilization and/or remobilization from the bottom sediment to the water column. Furthermore, the Geoaccumulation Index and the Enrichment Factor reveal that Zn, Pb, and Cd are enriched in the sediments. The results suggest that the effluents from various traditional mining waste sites in both countries are the main source of heavy metal contamination in the sediments of Lake Titicaca.

Influência das cores na motivação para leitura das obras de literatura infantil / Colors influence in reading motivation of literature infantile PIECES

Objetivou-se estudar a influência das cores na preferência por texto de literatura infantil e na motivação para leitura. Atuaram como participantes 30 pré-escolares com idade de 4 a 6 anos, metade de cada gênero. Os dados foram colhidos via questionário, situação de escolha e leitura de história. Os resultados mostraram que meninos e meninas discordam quanto à preferência por cores, escolha de livro por cor e do que mais gostam no livro. Não há diferença de gênero quanto a gostar de livros de história, de ouvir a leitura de história, nem quanto à posse deste objeto sendo esta muito limitada nos dois grupos, também não diferem sobre o que lembram da história lida para eles. Os professores precisam recorrer a estratégias específicas para meninos e meninas para respeitar as diferenças. É recomendável desenvolver programas que facilitem o acesso aos livros(AU)

The aim was to study the colors influence in the preference by text of infantile literature and in motivation to reading. Were participants 30 preschoolers aged 4 to 6 years old, half of each gender. The data was collected by questionnaire, choice's situation and story reading. The results showed discrepancies between girls and boys concerning colors` preference, choice of book by color and about what they liked more in the book. There is no gender difference about appreciation of story book, to listen to a story, to have books, even with this condition very limited in the two groups, they also did not differ in what they remember of the story. The teachers must use specific strategies for boys and girls in order to respect the differences. It is recommended to develop programs to facilitate access to books(AU)

El objetivo fue estudiar la influencia de los colores en la preferencia por textos de literatura infantil y en la motivación para la lectura. Participaron 30 niños del jardín de infancia con edad entre 4 y 6 años, siendo la mitad de cada sexo. Los datos fueron cosechados por medio de un cuestionario, situación de elección y lectura de historia. Los resultados mostraron que los varones y las chicas presentaron diferencias en relación a las preferencias por colores, la elección de libros por color y sobre lo que más les gusta del libro. No hubo diferencia de género en el hecho de gustar de libros de historias, de oír la lectura de historias, ni en relación a poseer ese objeto, siendo esta última muy limitada en los dos grupos. Tampoco se diferenciaron en relación a lo que recuerdan de la historia que les leyeron. Los maestros deben recurrir a estrategias específicas para varones y chicas para respetar las diferencias. Se recomienda desarrollar programas que faciliten el acceso a los libros(AU)

Influência das cores na motivação para leitura das obras de literatura infantil / Colors influence in reading motivation of literature infantile PIECES

Objetivou-se estudar a influência das cores na preferência por texto de literatura infantil e na motivação para leitura. Atuaram como participantes 30 pré-escolares com idade de 4 a 6 anos, metade de cada gênero. Os dados foram colhidos via questionário, situação de escolha e leitura de história. Os resultados mostraram que meninos e meninas discordam quanto à preferência por cores, escolha de livro por cor e do que mais gostam no livro. Não há diferença de gênero quanto a gostar de livros de história, de ouvir a leitura de história, nem quanto à posse deste objeto sendo esta muito limitada nos dois grupos, também não diferem sobre o que lembram da história lida para eles. Os professores precisam recorrer a estratégias específicas para meninos e meninas para respeitar as diferenças. É recomendável desenvolver programas que facilitem o acesso aos livros.

The aim was to study the colors influence in the preference by text of infantile literature and in motivation to reading. Were participants 30 preschoolers aged 4 to 6 years old, half of each gender. The data was collected by questionnaire, choice's situation and story reading. The results showed discrepancies between girls and boys concerning colors' preference, choice of book by color and about what they liked more in the book. There is no gender difference about appreciation of story book, to listen to a story, to have books, even with this condition very limited in the two groups, they also did not differ in what they remember of the story. The teachers must use specific strategies for boys and girls in order to respect the differences. It is recommended to develop programs to facilitate access to books.

El objetivo fue estudiar la influencia de los colores en la preferencia por textos de literatura infantil y en la motivación para la lectura. Participaron 30 niños del jardín de infancia con edad entre 4 y 6 años, siendo la mitad de cada sexo. Los datos fueron cosechados por medio de un cuestionario, situación de elección y lectura de historia. Los resultados mostraron que los varones y las chicas presentaron diferencias en relación a las preferencias por colores, la elección de libros por color y sobre lo que más les gusta del libro. No hubo diferencia de género en el hecho de gustar de libros de historias, de oír la lectura de historias, ni en relación a poseer ese objeto, siendo esta última muy limitada en los dos grupos. Tampoco se diferenciaron en relación a lo que recuerdan de la historia que les leyeron. Los maestros deben recurrir a estrategias específicas para varones y chicas para respetar las diferencias. Se recomienda desarrollar programas que faciliten el acceso a los libros.

História natural da angina do peito / Natural history of angina pectoris

Os autores apresentam uma casuística de 248 pacientes portadores de angina do peito, que pertenceram à clínica particular do prof. Jairo Ramos, com evoluçäo conhecida durante 30 anos. Relatam as intercorrências e descrevem a incidência de infarto do miocárdio, fazendo consideraçöes da sobrevida nos vários períodos. Concluem pela necessidade de estabelecer o diagnóstico precocemente e salientam a importância de conhecer a história natural da angina do peito.

Alteraçöes metabólicas e nutricionais e orientaçäo dietética para pacientes submetidos a transplante renal / Metabolic and nutritional changes in the dietetic orientation to patients submitted to kidney transplantation

A recomendaçäo nutricional após o transplante renal (Tx) está vinculado à quantidade de drogas imunossupressoras utilizadas, especialmente glicocorticóides e ciclosporina, que causam efeitos colaterais metabólicos que interagem com anormalidades metabólicas e nutricionais prévias surgidas durante todo o período de tratamento dialítico. Para contrapor os efeitos das drogas imunossupressoras no catabolismo e na depleçäo de massa muscular recomenda-se ingesstäo protéica de até 1,3 a 1,5 g/kg/dia, que a dose de glicocorticóides tenha atingido níveis baixos de manutençäo quando a recomendaçäo passa para 1,0 g/kg/dia. A restriçäo calórica pode implicar em balanço nitrogenado negativo, e o excesso pode causar obesidade. Assim, no primeiro mês, recomenda-se 30 a 35 kcal/kg/dia e, na fase de manutençäo, em torno de 25 kcal/kg/dia, suficientes para manter o peso ideal. A porcentagem de lipídeos näo deve ultrapassar 30 por cento das calorias totais e a ingestäo de colesterol deve ser menor de 300 mg/dia para prevenir hipercolessterolemia. Näo säo necessárias restriçöes à ingestäo de eletrólitos, exceto o sódio na presença de hipertensäo arterial e edema. Näo é necessária a suplementaçäo vitamínica. Imediatamente após o transplante os pacientes devemm ser orientados a respeito dos riscos de obesidade, perda de massa muscular e dislipidemias e encorajados a iniciar um programa gradual de atividade física.

Ciência e tecnologia no Brasil: a capacitaçäo brasileira para a pesquisa científica e tecnológica - v.3 / Science and technology in Brazil: the brazilian capacitation to the technological and scientific research - v.3

Estuda a situaçäo da pesquisa e capacitaçäo de recursos humanos na área da saúde, no Brasil. Analisa as seguintes áreas: médica, odontológica, enfermagem, educaçäo física e terapia ocupacional. (NMPM)

Estimativa do número de potenciais doadores de órgäos na cidade de Säo Paulo / Estimation of the number of potential donors of organs in the city of Säo Paulo, Brazil

OBJETIVO. Existe um conceito de que se realiza um número pequeno de transplante de órgäos devido à falta de doadores ou do grande índice de recusa dos familiares com relaçäo à doaçäo. Este trabalho tem por objetivo avaliar o potencial número de doadores de órgäos na cidade de Säo Paulo. MATERIAL E MÉTODOS. Estudamos o número de necrópsias realizadas diariamente por morte violenta no Instituto Médico Legal (IML) da cidade de Säo Paulo, nos anos de 1990 e 1991, e os doadores referidos à central de captaçäo de órgäos do Hospital Säo Paulo (HSP) nesse mesmos período. RESULTADOS. Nos anos de 90 e 91 foram realizadas, respectivamente, 11.601 e 11.607 necrópsias. A análise de 500 necrópsias de 10/90 e 1.039 necrópsias de 5.91 demonstra que 27% destes cadáveres tiveram o traumatismo craniencefálico como causa única de óbito e, destes 70% foram atendidos em algum Hospital antes de serem encaminhados ao IML. Neste mesmo período a equipe de procura de órgäos do HSP recebeu notificaçäo de 296 possíveis doadores, das quais 219 famílias foram abordadas com relaçäo à doaçäo e 59% delas autorizaram a doaçäo. CONCLUSÄO. Considerando o número de óbitos exclusivamente por TCE que passaram por algum hospital e a taxa de doaçöes, existe um número de potenciais doadores em Säo Paulo suficiente para saturar a capacidade de trabalho de todas as equipes em atividade, desde que o sistema de procura seja eficiente