Ecosystem service valuation method through grey water footprint in partially-monitored subtropical watersheds.

The valuation of ecosystem services of pollution regulation in basins with partial monitoring does not have only one consolidated methodology which can be applied in all countries, biomes and across spatio-temporal scales. While different metrics can incorporate elements of uncertainty for decision makers, changes in land use, climate and sectoral demands in basins increase the need for the efficiency and complexity of valuation methods. Here, based on adapting a pre-existing method, we present a new ecosystem service valuation applied to river basins under different characteristics in the biomes of the Atlantic Forest and Brazilian savannah. Our assumptions of ecosystem service valuation concern an analogy based on willingness-to-pay for not marketable services, but adapted by data from the river basins' ecohydrological monitoring. First, the method depicts river ecosystem valuation with probabilistic criteria of both the water yield, as supply, and the grey Water Footprint (greyWF), as demand. Second, we introduced the comparison between water supply and demand carried out on the continuous flow regime and monitored loads in rivers with different land uses, sizes and biomes. Third, this new ecosystem service valuation method enabled us to quickly visualize the possible stages of sustainability concerning the Brazilian legal framework among different basins. The methodology was applied in 12 Brazilian river basins, with drainage areas between 17 and 26,500 km2, and changes in land use with variable percentages of urban (62-92%), forest (51-84%) and agriculture (51-89%) areas. The most polluted basins, with greyWF values far above those allowed, have the most significant, almost asymptotic valuation curves. Results range from a minimum reference value of 61 US$/ha/year for conservation, adapted from the Brazilian Water Producer, to US$ 330 for restoring high polluted basins. The results show the viability of this method and discuss further opportunities for water security, especially for climate change and non-stationary sectorial demands.

[Familial hemifacial spasm: report of 2 cases]. / Espasmo hemifacial familiar. Relato de dois casos.

The authors report the clinical and angiographical findings of two cases of familial hemifacial spasm. This is the fifth description in the literature and presents mother and daughter at the ages of 76 and 51 respectively, in whom the left side was affected. They underwent exams of angioresonance that showed dolichobasilar with left side origin in both patients. The exams also demonstrated postero-inferior cerebellar artery very developed and irregularities in the walls of the vertebral and basilar arteries suggestive of arteriosclerosis in the mother and slightly elongated intracranial vessels in the daughter. Literature review and etiology data of the hemifacial spasm are focused.

Acute orbital myositis. Case report.

The case of 22-year old, white woman with bilateral orbital myositis following an acute upper respiratory tract infection is reported. The most important clinical findings were ocular pain, proptosis, restricted eye motility and swelling of the eyelids. The enlarged eye muscles were seen on orbital computerized tomography scan. The clinical findings of inflammatory orbital myositis and clinical response to corticotherapy are emphasized.

[Blepharospasm: treatment with botulinum toxin]. / Blefaroespasmo: tratamento com toxina botulínica.

Blepharospasm is form of focal dystonia characterized by involuntary and repetitive contractions involving the orbicular oculi muscle. Fourteen patients with blepharospasm were submitted to botulinum toxin type A injections. Of these 14 cases, 6 were male and 8 female. The mean age was 58 years (range: 33 to 76 years) with illness duration ranging from 1 to 25 years (average: 7.3 years). All patients have been treated with conventional therapies with poor results, but presented a good response to botulinum toxin type A. The average latent period was 3 days (range: 0 to 10); maximum effect of treatment was observed after 16 days. The mean duration of maximum response was 90 days. The main side effects of botulinum toxin injections were ptosis and lagophtalmos.

[Hemifacial spasm: study using magnetic resonance angiography]. / Espasmo hemifacial: estudo pela angiografia por ressonância magnética.

Nine patients with "idiopathic" hemifacial spasm were evaluated with cranial magnetic resonance imaging and angiography. Alterations of the posterior fossa vasculature, possibly related to the facial nerve irritation, were found in 8 patients (88%). Magnetic resonance angiography is a noninvasive procedure and appears to be a sensitive method to evaluate the hemifacial spasm etiology.

[Precocious Parkinson's disease associated with "eye-of-the-tiger" type pallidal lesions]. / Parkinsonismo precoce associado a lesões palidais de tipo "eye-of-the-tiger".

We report the case of a 56-years-old woman patient, born to unrelated parents, who since 26-years-old gradually developed bradykinesia, rigidity, tremor of both hands, and speech and gait difficulties. Her past history was unremarkable. There was no family history of neurologic disease. She was admitted to our Hospital at age 39 and at that time she presented a full parkinsonian syndrome. The following tests were normal or negative: routine blood studies, serum copper, ceruloplasmin and cerebrospinal fluid examination. There was not Kayser-Fleicher ring, and fundoscopic examination revealed no abnormalities. Levodopa was introduced and response was good for more than ten years, despite early-onset of dyskinesias (three months after the introduction of the drug). After 30 years under levodopa she still presents a moderate response but with severe fluctuations of the motor performance. Except for slowness of cognition she developed no other neuropsychological impairments, and a recent neurological examination disclosed no abnormalities besides a parkinsonian syndrome. One year ago, a magnetic resonance imaging (MRI) was performed and showed bilateral, symmetrical lesions with "eye-of-the-tiger" pattern. This case illustrates the pathological heterogeneity of early-onset parkinsonism and suggests the possibility to find the typical MRI lesions seen in Hallervorden-Spatz disease in other degenerative affections involving globus pallidus.