[Transumbilical single-incision laparoscopic ureterolithotomy]. / Ureterolitotomía laparoscópica con incisión única transumbilical.

INTRODUCTION: laparoendoscopic single-site surgery (LESS) using transumbilical access and conventional laparoscopic instruments is a very attractive alternative to perform ureterolithotomy for ureteral stone with failed endourological management. MATERIAL AND METHOD: a 29-year-old woman presented with chronic right lumbar pain and a 1.2 cm impacted calculus localized at transition of abdominal to pelvic ureter. Semi-rigid ureteroscopy had failed to fragment the stone and shockwave lithotripsy was not available. Double-J ureteral catheter had been inserted preoperatively. We performed a transumbilical single-incision laparoscopic ureterolithotomy. Three conventional trocars were inserted in a single semi-circular umbilical incision. Right colon was detached and the ureter was identified. Calculus was extracted and the ureteral incision was closed with intracorporal sutures. RESULTS: ureterolithotomy was successfully completed, with all the operative steps performed transumbically. Operative time was 180 minutes. No single-port device or articulating and bent instruments were utilized. Estimated blood loss was less than 50 mL. No intraoperative, access-related and postoperative complications took place. The duration of hospitalization was 24 hours and scarless appearance was observed on postoperative day 15. CONCLUSION: transumbilical single-incision laparoscopic ureterolithotomy is feasible and safe. This approach offers an inherent cosmetic advantage and few postoperative discomfort. Additional experience and continued investigation are warranted.

A sesquiterpene drimane with antinociceptive activity from Drimys winteri bark.

Along with three known drimanes, polygodial. 1-beta-(p-methoxycinnamoyl) polygodial and mukaadial, the sesquiterpene drimane named drimanial was isolated from the bark of Drimys winteri (Winteraceae). Its structure was elucidated based on spectroscopic evidence. Drimanial exhibited antinociceptive action against acetic acid induced pain, being about 3-fold less active than polygodial.

[Brazilian biomedical publications in the international scientific literature. Endemic communicable diseases]. / Publicações biomédicas brasileiras na literatura científica internacional. Doenças endêmicas transmissíveis.

The number of Brazilian periodicals listed in the Index Medicus dropped from 70 in 1964 to 15 in 1983, or 78%, while the total number of listed periodicals from other countries fell only 11%. The total number of articles published in Brazil on Chagas' disease, schistosomiasis, leishmaniasis, leprosy, malaria, and filariasis, and listed in the Index Medicus did not change significantly between 1965 and 1982, because, with the exception of the journal O Hospital, the Brazilian periodicals that published 74% of all articles on those diseases remained listed throughout the period considered. The predominant subjects in articles on endemic diseases were Chagas' disease and schistosomiasis, and in the later years there was a tendency to index more articles on basic than on applied research. The number of articles on Chagas' disease published by Brazilian authors directly in foreign journals increased considerably during the latter decade. Analysis of all the data together suggests that the developed countries select a specific portion of the Brazilian output of biomedical literature--which is kept listed in secondary and international publications or published directly in foreign journals--while another portion of the same output gradually loses visibility on the international scene.