Effects of squamous cell carcinoma and smoking status on oropharyngeal and laryngeal microbial communities.

BACKGROUND: Still, little is known about microbial dysbiosis in oropharyngeal and laryngeal tissue as risk factor for development of local squamous cell carcinoma. The site-specific microbiota at these regions in healthy and cancer tissue and their modulation by environmental factors need to be defined. METHODS: The local microbiota of cancer tissue and healthy controls was profiled by 16S rRNA gene amplicon sequencing and statistical analysis using 111 oropharyngeal and 72 laryngeal intraoperative swabs. RESULTS: Oropharynx and larynx harbor distinct microbial communities. Clear effects of both smoking and cancer were seen in the oropharynx whereas effects in the larynx were minor. CONCLUSION: The distinct microbial communities at larynx and oropharynx partially explain why the effects of cancer and smoking were distinct at those sites. Thus, the use of microbiota supposed to mirror community changes in another target location should be avoided and more studies on the actual cancerous environment are necessary.

Regional concentration of native fuelwood production in Rio Grande do Norte, Brazil (1990­2017) / Concentração regional da produção de lenha nativa no Rio Grande do Norte, Brasil (1990-2017)

This paper examined the regional concentration of native fuelwood production in Rio Grande do Norte, Brazil, between 1990-2017. Information on native fuelwood was gathered from forestry activities collected by the Brazilian Institute of Geography and Statistics (IBGE). This study analyzed the current situation and the spatial distribution of the state's fuelwood production by quartiles. The following indicators were used to measure market concentration: Gini Coefficient (G), Comprehensive Concentration Index (CCI), Herfindahl-Hirschman Index (HHI) and Concentration Ratio [CR(k)]. In Rio Grande do Norte, there was a -2.76% annual decrease in the production of native fuelwood, from 5,280 x10³ m³ (1990) to 777 x10³ m³ (2017). Classification of the municipalities by quartile revealed that most municipalities had low fuelwood production. The G inferred a very strong to absolute inequality for the municipalities and a weak to null inequality for the mesoregions.The CCI demonstrated no market concentration in the municipalities and a regional concentration in the mesoregions. The HHI corroborated the CCI by affirming the presence of a competitive market for the municipalities and microregions and a concentrated market in the mesoregions.The CR(k) of the four largest municipalities indicated a moderately low concentration. This study concluded that there is a competitive market structure for native fuelwood inthe state of Rio Grande do Norte.

Este artigo analisou a concentração regional da produção de lenha nativa do Rio Grande do Norte - Brasil, no período de 1990 a 2017. As informações da lenha nativa foram obtidas da produção da extração vegetal e da silvicultura, disponíveis no Instituto Brasileiro de Geografia e Estatística (IBGE). Analisou a conjuntura, a distribuição espacial da produção de lenha estadual por meio os quartis e mensurou a concentração por meio dos indicadores: Coeficiente de Gini (G), Índice de Concentração Compreensiva (CCI), Índice de Herfindahl-Hirschman (HHI) e Razão de Concentração [CR(k)]. Os resultados mostraram que houve decréscimo de -2,76% a.a. na produção de lenha nativa estadual, partindo de 5.280 x10³ m³ (1990) para 777 x10³ m³ (2017). O quartil municipal revelou que a maioria dos municípios produz pouca lenha; apesar do G ter inferido uma desigualdade muito forte a absoluta para os municípios produtores de lenha e fraca a nula para as mesorregiões, já o CCI mostrou para os municípios que é não concentrado e as mesorregiões tem concentração regional; HHI corroborou com esta afirmação mostrando um mercado altamente competitivo para os municípios e microrregiões e concentrado para as mesorregiões produtoras de lenha; o CR(k) dos quatro maiores municípios foi constatada uma concentração moderadamente baixa. Conclui-se que a lenha nativa do estado do Rio Grande do Norte possui estrutura de mercado competitiva.

Retrospective Study of the Analgesic Effect of Sacroiliac Joint Radiofrequency Denervation.

BACKGROUND: Interventional radiofrequency (RF) ablation techniques are indicated when an adequate effect is not obtained with conservative measures. OBJECTIVES: The primary objective of this study was to evaluate pain relief after RF denervation of the sacroiliac joint. The secondary objective was to evaluate pain intensity and relief duration. STUDY DESIGN: The study was retrospective. SETTING: The study was conducted at Vera Cruz Hospital, Campinas, Brazil. METHODS: Data were collected from the medical records of patients undergoing RF denervation for low back pain originating in the sacroiliac joint, from January 2015 to December 2017. There were 78 patients studied, between 18 and 65 years old, of both genders, ASA I or II, who underwent knee arthroscopic meniscectomy. The patients were submitted to denervation of sacroiliac joint by 3 types of RF (conventional, pulsed, and cooled). The following parameters were evaluated, number of patients who obtained ? 50% pain relief; pain intensity, measured using the visual analog scale (before the procedure and 15, 30, 90 and 180 days after, performed by the same evaluator); and the use of complementary analgesic for 2 weeks. RESULTS: Of the 78 included patients, 56 (71.8%) underwent conventional RF, 9 (11.5%) underwent pulsed RF, and 13 (16.7%) underwent cooled RF. There were losses to follow-up including 40 patients who underwent conventional RF, 5 who underwent pulsed RF, and 12 who underwent cooled RF, who were retained for 6 months. There was significant pain relief with the three types of RF for up to 6 months of follow-up, with no difference among the types. After 6 months, 90.2% of patients who underwent conventional RF, 100% who underwent pulsed RF, and 91.7% who underwent cooled RF maintained ≥ 50% pain relief. Complementary analgesics were used by 95% of the patients who underwent conventional RF, 80% who underwent pulsed RF, and 91% who underwent cooled RF 2 weeks after the procedure. There were mild adverse effects, such as edema, hematoma, and local pain, without complications. LIMITATIONS: As for limitations, the number of pulsed and cooled RF is low and in a retrospective study some data may be missing, especially from follow-up. CONCLUSIONS: RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect.

Sustentabilidade do licenciamento ambiental minerário em Minas Gerais: caso aplicado / Sustainability of the mineral environmental licensing in Minas Gerais: case applied

RESUMO A avaliação de impactos ambientais, introduzida por meio da Política Nacional de Meio Ambiente (PNMA), ganhou espaço primordialmente dentro do licenciamento ambiental, cujo modelo atual é questionado pela sua ineficácia em compensar ao ambiente a perda dos recursos naturais. Este estudo teve como objetivo analisar de forma técnica e legal o licenciamento ambiental minerário na Região do Alto São Francisco, Minas Gerais, por intermédio do histórico e fluxo atual dos processos, do levantamento de dados dos de Estudos de Impacto Ambiental, do cumprimento dos Termos de Referência e da legislação ambiental, analisando estes dados pelo método Analytic Hierarchy Process (AHP). Os resultados demonstraram que o licenciamento ambiental não cumpre a função de compensar os impactos socioambientais causados pela atividade nem os requisitos legais obrigatórios ao processo.

ABSTRACT The assessment of environmental impacts, introduced by the National Environmental Policy, has earned a place within the environmental licensing process, which is currently questioned due to its ineffectiveness to compensate nature for resources' loss. This study aimed at technically and legally assessing the mineral environmental licensing process in the Region of Alto São Francisco, Minas Gerais, through history and current flow of processes, as well as by surveying data from Studies on Environmental Impact, and compliance with the Terms of Reference and applicable environmental law, using the Analytic Hierarchy Process (AHP). The results showed that the environmental licensing process does not meet the needs for compensating the socioenvironmental impacts caused by activity and does not comply with the legal requirements that are mandatory in the process.

SN-38, the active metabolite of irinotecan, inhibits the acute inflammatory response by targeting toll-like receptor 4.

PURPOSE: Anticancer-drug efficacy seems to involve the direct interaction with host immune cells. Although topoisomerase I (Top I) inhibitors have been suggested to block LPS-evoked inflammation, the interaction between these drugs and toll-like receptor 4 (TLR4) is unaddressed. METHODS: SN-38, the active metabolite of the Top I inhibitor irinotecan, and TLR4 interaction was assessed using the in vitro luciferase nuclear factor-κB reporter assay, neutrophil migration to murine air-pouch, in silico simulation, and the thermal shift assay (TSA). Topotecan was used as a positive anti-inflammatory control. RESULTS: Non-cytotoxic concentrations of SN-38 attenuated LPS (a TLR4 agonist)-driven cell activation without affecting peptidoglycan (a TLR2 agonist)-activating response. Similarly, topotecan also prevented LPS-induced inflammation. Conversely, increasing concentrations of LPS reversed the SN-38 inhibitory effect. In addition, SN-38 abrogated LPS-dependent neutrophil migration and reduced TNF-α, IL-6, and keratinocyte chemoattractant levels in the air-pouch model, but failed to inhibit zymosan (a TLR2 agonist)-induced cell migration. A two-step molecular docking analysis indicated two potential binding sites for the SN-38 in the MD-2/TLR4 complex, the hydrophobic MD-2 pocket (binding energy of - 8.1 kcal/mol) and the rim of the same molecule (- 6.9 kcal/mol). The topotecan also bound to the MD-2 pocket. In addition, not only the lactone forms, but also the carboxylate conformations of both Top I inhibitors interacted with the MD-2 molecule. Furthermore, the TSA suggested the interaction of SN-38 with MD-2. CONCLUSIONS: Therefore, SN-38 inhibits acute inflammation by blocking LPS-driven TLR4 signaling. This mechanism seems to be shared by other Top I inhibitors.

Hepatitis C virus genotypes in hemodialysis patients in Angola.

To our knowledge, there are no published data on hepatitis C virus (HCV) genotypes in Angola. This study aimed at assessing the distribution of HCV genotypes in seropositive hemodialysis patients in Luanda. Among 51 HCV-positive subjects included, viremia was detected in 27 (53%). HCV genotyping was performed by bidirectional sequencing of the 5'-untranslated region by the Sanger method. HCV genotype 4 was largely predominant (20 cases; 74%), followed by genotypes 1b (5 cases; 18.5%), 1a and 2 (one case each; 3.7%). These results suggest that the distribution of HCV genotypes in Angola is similar to that reported from other Central African countries.

Evaluation of topical corticosteroids in children with phimosis through morphological and immunohistochemical analyses of the foreskin.

INTRODUCTION: Histopathological analysis of the foreskin has become more common in the last two decades. OBJECTIVES: This study aims to analyze the morphology of the foreskin and determine the effects of topical corticosteroid therapy on this tissue. MATERIALS AND METHODS: We retrospectively evaluated forty foreskin samples from children aged from 2 years to 15 years with phimosis undergoing circumcision at our institution over a 2-year period. In the foreskin samples, we analyzed the elastic fibers (Verhoeff), epidermal thickness (hematoxylin and eosin), and Annexin 1 and Langerhans cells (LCs) (immunohistochemistry). RESULTS: In the present study, 18 (45%) patients made use of topical corticosteroids, and 22 (55%) did not, while 4 (10%) had a history of balanoposthitis as previous complication. Forty patients were divided according to the parameter analyzed: with or without previous complication and with or without previous topical corticotherapy. Annexin 1 expression was significantly higher in group with a history of complications when compared with group without complications (P = 0.024) and lower in the group of those who used corticosteroids when compared with those who did not used corticosteroids (P = 0.364). In the analysis of all samples, the density of mature LCs was significantly higher when compared with immature LCs (P < 0.0001). The density of immature LCs was significantly higher in patients without previous complications when compared with group with complications (P = 0.028). CONCLUSIONS: These findings contribute to a better understanding of the histopathological aspects of previous complications and of treatment with corticosteroids in children with phimosis.

Effects of Mechanical Insufflation-Exsufflation on Airway Mucus Clearance Among Mechanically Ventilated ICU Subjects.

BACKGROUND: Few studies have evaluated the effects of mechanical insufflation-exsufflation (MI-E) in subjects on mechanical ventilation. Therefore, this study aimed to evaluate the effectiveness of MI-E on airway mucus clearance among mechanically ventilated ICU subjects. METHODS: A randomized, parallel-group, open-label trial was conducted between June and November 2017 in a single, mixed ICU. Adult ICU subjects receiving mechanical ventilation for > 24 h with stable ventilatory and hemodynamic status were randomized to receive either standard respiratory physiotherapy alone (control group) or respiratory physiotherapy by using an MI-E device (intervention group). The primary outcome was the weight of aspirated airway mucus after study interventions. Secondary outcomes included variation in static lung compliance (ΔCL), airway resistance (ΔRaw), work of breathing (ΔWOB) in relation to the pre-intervention period, and hemodynamic and ventilator complications during the procedures. RESULTS: There were 90 subjects in each group. The mean ± SD weight of the aspirated airway mucus was higher in the intervention group than in the control group (2.42 ± 2.32 g vs 1.35 ± 1.56 g, P < .001). The ΔCL values in the intervention group were higher than those in the control group (1.76 ± 4.90 mL/cm H2O vs -0.57 ± 4.85 mL/cm H2O, P = .001). The ΔRaw and ΔWOB values were similar between the groups. No hemodynamic or ventilatory complications were observed. CONCLUSIONS: Among the general ICU subjects receiving mechanical ventilation, use of an MI-E device during respiratory physiotherapy resulted in a larger amount of airway mucus clearance than respiratory physiotherapy alone. (ClinicalTrials.gov registration NCT03178565.).

[Hidradenocarcinoma of the Scrotum with Lymph Node Metastasis]. / Hidradenocarcinoma do Escroto com Metastização Ganglionar.

Hidradenocarcinoma is a rare neoplasm of the eccrine cells of the sweat glands, usually asymptomatic with slow growing and higher incidence between 50 and 80 years, occurring in both sexes and preferentially located in the palmar, plantar, frontal, axillary and nuchal regions. It has an aggressive behavior, with high rate of local recurrence and distance metastasis, associated with a poor prognosis. We present a case of hidradenocarcinoma of the scrotum manifested by lymph node metastasis through an exercise of clinical and histological differential diagnosis of an inguinal adenopathy in a young adult.

O hidradenocarcinoma é uma neoplasia rara das células écrinas das glândulas sudoríparas, geralmente assintomática e de crescimento lento, com maior incidência entre os 50 e os 80 anos, atingindo ambos os sexos e com localização preferencial nas regiões palmar, plantar, frontal, axilar e nuca. Tem um comportamento agressivo, com alta taxa de recorrência local e metastização à distância, associando-se a mau prognóstico. Apresentamos um caso raro de hidradenocarcinoma do escroto manifestado por metastização ganglionar justificando exercício de diagnóstico diferencial clínico e histológico de adenopatia inguinal num adulto jovem.

Mechanical ventilation weaning protocol improves medical adherence and results.

INTRODUCTION: Implementation of a weaning protocol is related to better patient prognosis. However, new approaches may take several years to become the standard of care in daily practice. We conducted a prospective cohort study to investigate the effectiveness of a multifaceted strategy to implement a protocol to wean patients from mechanical ventilation (MV) and to evaluate the weaning success rate as well as practitioner adherence to the protocol. METHODS: We investigated all consecutive MV-dependent subjects admitted to a medical-surgical intensive care unit (ICU) for >24h over 7years. The multifaceted strategy consisted of continuing education of attending physicians and ICU staff and regular feedback regarding patient outcomes. The study was conducted in three phases: protocol development, protocol and multifaceted strategy implementation, and protocol monitoring. Data regarding weaning outcomes and physician adherence to the weaning protocol were collected during all phases. RESULTS: We enrolled 2469 subjects over 7years, with 1,943 subjects (78.7%) experiencing weaning success. Physician adherence to the protocol increased during the years of protocol and multifaceted strategy implementation (from 38% to 86%, p<0.01) and decreased in the protocol monitoring phase (from 73.9% to 50.0%, p<0.01). However, during the study years, the weaning success of all subjects increased (from 73.1% to 85.4%, p<0.001). When the weaning protocol was evaluated step-by-step, we found high adherence for noninvasive ventilation use (95%) and weaning predictor measurement (91%) and lower adherence for control of fluid balance (57%) and daily interruption of sedation (24%). Weaning success was higher in patients who had undergone the weaning protocol compared to those who had undergone weaning based in clinical practice (85.6% vs. 67.7%, p<0.001). CONCLUSIONS: A multifaceted strategy consisting of continuing education and regular feedback can increase physician adherence to a weaning protocol for mechanical ventilation.

Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy.

BACKGROUND AND OBJECTIVES:: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING:: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS:: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included. The local group (LG) received local infiltration (0.75% ropivacaine) under general anesthesia; the spinal group (SG) received subarachnoid block (2 ml of 0.5% bupivacaine). Analgesic supplementation consisted of fentanyl for LG and lidocaine for SG. Postoperative pain intensity, sphincter relaxation, lower-limb strength, time to discharge, analgesic dose over one week and adverse effects were assessed. RESULTS:: Eleven LG patients (52.4%) required supplementation, but no SG patients. Pain intensity was higher for LG up to 120 min, but there were no differences at 150 or 180 min. There were no differences in the need for paracetamol or tramadol. Times to first analgesic supplementation and hospital discharge were longer for SG. The adverse effects were nausea, dizziness and urinary retention. CONCLUSIONS:: Pain intensity was higher in LG than in SG over the first 2 h, but without differences after 150 and 180 min. Time to first supplementation was shorter in LG. There were no differences in doses of paracetamol and tramadol, or in adverse effects. REGISTRATION:: ClinicalTrials.gov NCT02839538.

Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy / Estudo clínico randomizado do efeito analgésico da infiltração local versus bloqueio espinal para hemorroidectomia

ABSTRACT BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included. The local group (LG) received local infiltration (0.75% ropivacaine) under general anesthesia; the spinal group (SG) received subarachnoid block (2 ml of 0.5% bupivacaine). Analgesic supplementation consisted of fentanyl for LG and lidocaine for SG. Postoperative pain intensity, sphincter relaxation, lower-limb strength, time to discharge, analgesic dose over one week and adverse effects were assessed. RESULTS: Eleven LG patients (52.4%) required supplementation, but no SG patients. Pain intensity was higher for LG up to 120 min, but there were no differences at 150 or 180 min. There were no differences in the need for paracetamol or tramadol. Times to first analgesic supplementation and hospital discharge were longer for SG. The adverse effects were nausea, dizziness and urinary retention. CONCLUSIONS: Pain intensity was higher in LG than in SG over the first 2 h, but without differences after 150 and 180 min. Time to first supplementation was shorter in LG. There were no differences in doses of paracetamol and tramadol, or in adverse effects. REGISTRATION: ClinicalTrials.gov NCT02839538.

RESUMO CONTEXTO E OBJETIVO: A analgesia pós-operatória e a recuperação precoce são relevantes para a alta hospitalar. O objetivo primário deste estudo foi comparar a eficácia analgésica da infiltração perianal e da anestesia subaracnóidea para hemorroidectomia. O objetivo secundário foi comparar o tempo para alta, efeitos adversos e complicações. TIPO DE ESTUDO E LOCAL: Estudo randomizado prospectivo e comparativo, no Hospital Dr. Mário Gatti. MÉTODOS: Foram incluídos 40 pacientes com idades 18-60 anos, na categoria 1 ou 2 de status físico da Sociedade Americana de Anestesiologistas. O grupo local (LG) recebeu infiltração local (ropivacaína a 0,75%) sob anestesia geral; o espinal (SG) recebeu bloqueio subaracnóideo (2 ml de bupivacaína a 0,5%). A suplementação analgésica foi com fentanil para LG e lidocaína para SG. Foram avaliados: intensidade da dor no pós-operatório, relaxamento do esfíncter, força dos membros inferiores, tempo de alta, dose de analgésico em uma semana e efeitos adversos. RESULTADOS: Onze (52,4%) pacientes em LG necessitaram de complementação, e nenhum em SG. A intensidade da dor foi maior para LG até 120 minutos, sem diferenças em 150 ou 180 minutos. Não houve diferenças na necessidade de paracetamol ou tramadol. O tempo para a primeira complementação analgésica e a alta hospitalar foram maiores para SG. Os efeitos adversos foram náuseas, tonturas e retenção urinária. CONCLUSÕES: A intensidade da dor foi maior na LG que na SG nas primeiras 2 horas, porém sem diferenças após 150 e 180 minutos. O tempo para a primeira suplementação foi menor na LG; sem diferenças nas doses de paracetamol e tramadol e efeitos adversos. REGISTRO: ClinicalTrials.gov NCT02839538.

Avaliação da cobertura do solo como indicador de gestão de recursos hídricos: um caso de estudo na sub-bacia do Córrego dos Bois, Minas Gerais / Evaluation of the land cover as water management indicator: a case study at Córrego dos Bois sub-basin, Minas Gerais

RESUMO No presente artigo realizou-se uma avaliação da ocupação da sub-bacia Córrego dos Bois, no município de Oliveira (MG) - com base nos resultados foram obtidas as classes de uso e ocupação do solo, delimitadas as áreas de preservação permanente, identificadas a ocorrência de conflito entre o uso do solo e a legislação e elaborados indicadores ambientais. Foi construído um mosaico a partir de três imagens provenientes dos satélites RapidEye. O método de classificação adotado foi a classificação orientada a objetos e para isso utilizou-se o software Ecognition Developer 8.0®. O algoritmo utilizado no processo de classificação foi o vizinho mais próximo, que leva em consideração a proximidade dos objetos segmentados na imagem em um espaço de características. A avaliação da exatidão da classificação foi realizada com base na coleta de amostras de acurácia obtidas aleatoriamente em áreas previamente conhecidas na imagem. Foram obtidas as classes água, café, eucalipto, floresta, infraestrutura, mineração, pastagem, rodovia, solo exposto e várzea, e encontradas somente duas categorias de áreas de preservação permanente (APP), ao longo dos cursos d’água e no entorno das nascentes. Conclui-se que a área total da sub-bacia Córrego dos Bois é de 1.540,18 ha, dos quais 40,70% são ocupados por pastagem, 35,84%, por cafezal e 18,84%, por vegetação nativa. O conflito do uso e da ocupação do solo nas áreas destinadas à preservação corresponde a 25,58% do território das APPs.

ABSTRACT In the present work, we evaluated the occupation of the Córrego dos Bois sub-basin, in the municipality of Oliveira County, Minas Gerais State, in Brazil - based on it, it has been obtained land cover classes, defined areas of permanent preservation, identified the conflict among land use and environmental laws, and calculated environmental indicators. Initially, it was constructed a mosaic of three RapidEye images. The classification method used was the object-based classification with the Ecognition Developer 8.0® software. The classifier algorithm applied was the nearest neighbor, which takes in account the proximity of segmented objects in an image in the feature space. A random sampling, in some previously defined areas, performed the evaluation of the classification accuracy. The land cover classes obtained were water bodies, coffee farming, Eucalyptus forests, native forests, buildings, mining, pasture, road, bare land and floodplain. It was identified only two categories of preservation permanent areas in the study area: adjacent to rivers and springs. It concludes that the total area of the Córrego dos Bois sub-basin is 1,540.18 hectares, where 40.70% are pastures, 35.84% are coffee plantations, and 18.84% are native forests. The corresponding conflict of the land use in the preservation areas is 25.58%.

Maternal Na+ intake induces renal function injury in rats prevented by a short-term angiotensin converting enzyme inhibitor.

The Na+ -ATPase, a secondary pump in the proximal tubule, is only weakly responsive to angiotensin II in adult offspring exposed perinatally to high Na+ intake. We have investigated whether the offspring from mothers given 0.3 mol/L NaCl show an ineffective angiotensin II action to increase in blood pressure. It was hypothesized that functional alterations at adult life are associated with the number of angiotensin II-positive cells in the developing kidney, with increased oxidative stress in maternal/foetal organs, or with morphometrical changes in placentas. Wistar female rats were maintained on 0.3 mol/L NaCl in their drinking water from 20 days before conception until weaning. After weaning, some of the male offspring were treated with enalapril for 21 days. Glomerular filtration rate was recorded up to 210 days of age, when mean arterial pressure was measured after infusion of angiotensin II. To investigate the placenta and foetal kidneys, mothers on tap water or NaCl were also treated with alpha-tocopherol, pregnancy being interrupted on the 20th day. There were no changes in the number of cells positive for angiotensin II in the foetal kidney and unchanged lipid peroxidation in the placenta of offspring exposed to NaCl, but the intermediate trophoblast area in the junctional zone was increased, possibly reducing maternal-foetal exchange. Glomerular filtration rate was reduced and there was an attenuated effect of angiotensin II on elevation of blood pressure, which could be mediated by an elevated angiotensin II during early life, once these disturbances had been prevented by early and short-term treatment with enalapril.

The legal reserve: historical basis for the understanding and analysis of this instrument / A evolução da reserva legal: fundamentos para análise e compreensão do instrumento

ABSTRACT: The revisions made in the Forest Code (FC) in 2012 appear to have promoted the weakening of the legal reserve (LR), which after at least 80 years of development, had become established in the Brazilian legal system as an instrument of environmental conservation. This study investigated the possibility of disruption in the implementation of the LR and was developed using qualitative approaches, including bibliographical and documental analyses, to assess the historical construction and legal format of the instrument over time. It was concluded that the current Forest Code broke the trend of development of the LR as an instrument of environmental conservation that was promoted by previous codes and removed the conditions necessary for its effectiveness and existence.

RESUMO: Revisões ao Código Florestal feitas em 2012 parecem ter promovido a fragilização da Reserva Legal que, após pelo menos 80 anos de construção, firmou-se no ordenamento jurídico brasileiro como instrumento de conservação ambiental. Este trabalho investigou a hipótese de ruptura do processo de evolução da Reserva Legal. Desenvolveu-se uma pesquisa qualitativa, delineada por métodos bibliográficos e documentais, a qual analisou a construção histórica do instrumento e seu formato jurídico ao longo do tempo. Concluiu-se que o atual Código Florestal Brasileiro rompeu a tendência de construção da Reserva Legal como instrumento de conservação ambiental, promovida pelos códigos anteriores, retirando condições necessárias para sua eficácia e existência.

Alternativas para lograr la revascularización arterial total usando una o ambas arterias mamarias y el remanente distal de una de ellas como únicos injertos / Alternatives to achieve total arterial revascularization using one or both mammary arteries and distal remnant of them as unique grafts

Introducción: Toda cirugía de revascularización miocárdica debe estar dirigida a lograr que el paciente permanezca el mayor tiempo posible sin necesidad de una nueva revascularización. La revascularización arterial total contribuye a alcanzar este propósito. Objetivo: Demostrar que ambas arterias mamarias pueden ser utilizadas, en varias configuraciones, para lograr la revascularización arterial total. Métodos: Se incluyeron 35 pacientes, 29 de género masculino y 6 del femenino, con edad promedio de 54,2 años, a quienes se les revascularizaron una o ambas arterias mamarias, en el período entre enero de 2012 y septiembre de 2014, para un seguimiento medio de 13,1 meses. El valor del Euroscore aditivo fue de 0 para los hombres y 1 para las mujeres. Resultados: Se describieron siete configuraciones para lograr la revascularización arterial total, usando una o ambas arterias mamarias y el remanente distal de una de las arterias mamarias como únicos injertos. No hubo fallecimientos ni complicaciones mayores en los pacientes revascularizados. Seis meses después todos permanecían asintomáticos y sin nuevos signos de isquemia en los territorios revascularizados. Conclusiones: La revascularización arterial total, utilizando una o ambas arterias mamarias y el remanente distal de una de ellas es posible y arroja buenos resultados en pacientes seleccionados.

Introduction: The aim of all coronary artery bypass grafts should be to allow patients to stay as long as possible without the need to repeat revascularization. Total arterial revascularization contributes to achieving these purposes. Objective: To demonstrate that both mammary arteries can be used in various configurations to achieve total arterial revascularization. Methods: 35 patients were included, 29 male and 6 female, with age average of 54.2 years, who were revascularized with one or both mammary arteries in the period between January 2012 and September 2014, with a mean follow-up time of 13.1 months. The additive EuroSCORE was 0 for men and 1 for women. Results: Seven configurations are described to achieve total arterial revascularization using one or both mammary arteries and the distal remnant of a mammary arteries as single grafts. There were no deaths or major complications in patients revascularized. Six months later, all were asymptomatic with no new signs of ischemia in revascularized territories. Conclusions: Total arterial revascularization using one or both mammary arteries and distal remaining one is possible and gives good results in selected patients.

Radio-frequency energy harvesting for wearable sensors.

The use of wearable biomedical sensors for the continuous monitoring of physiological signals will facilitate the involvement of the patients in the prevention and management of chronic diseases. The fabrication of small biomedical sensors transmitting physiological data wirelessly is possible as a result of the tremendous advances in ultra-low power electronics and radio communications. However, the widespread adoption of these devices depends very much on their ability to operate for long periods of time without the need to frequently change, recharge or even use batteries. In this context, energy harvesting (EH) is the disruptive technology that can pave the road towards the massive utilisation of wireless wearable sensors for patient self-monitoring and daily healthcare. Radio-frequency (RF) transmissions from commercial telecommunication networks represent reliable ambient energy that can be harvested as they are ubiquitous in urban and suburban areas. The state-of-the-art in RF EH for wearable biomedical sensors specifically targeting the global system of mobile 900/1800 cellular and 700 MHz digital terrestrial television networks as ambient RF energy sources are showcased. Furthermore, guidelines for the choice of the number of stages for the RF energy harvester are presented, depending on the requirements from the embedded system to power supply, which is useful for other researchers that work in the same area. The present authors' recent advances towards the development of an efficient RF energy harvester and storing system are presented and thoroughly discussed too.

Comportamiento de los pacientes ancianos operados de cirugía cardíaca con circulación extracorpórea / Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

Introducción: Cada día se incrementa el número de pacientes añosos con enfermedades cardiovasculares graves, que requieren de un acto quirúrgico para devolverle cierta calidad de vida que los haga socialmente útiles, a pesar de los riesgos. Objetivos: Analizar el comportamiento de los pacientes añosos sometidos a cirugía cardíaca con circulación extracorpórea. Método: Se realizó un estudio descriptivo, retrospectivo, transversal, con los pacientes de más de 65 años de edad intervenidos quirúrgicamente en el Cardiocentro Ernesto Che Guevara, de Santa Clara, desde enero del 2013 a marzo del 2014. Resultados: El 73,1 por ciento fueron hombres y predominaron los pacientes comprendidos entre los 65 y 70 años con un 67,3 por ciento. La revascularización miocárdica fue la cirugía de más incidencia y tiempos prolongados de circulación extracorpórea. El 98,1 por ciento pade-cían de hipertensión arterial. Las complicaciones posoperatorias más frecuentes fueron la disfunción renal y el bajo gasto grave con 44,2 y 34,6 por ciento respectivamente. Conclusiones: Predominaron los hombres, de 65 a 70 años, hipertensos, sometidos arevascularización miocárdica con circulación extracorpórea prolongada, siendo la disfunción renal la complicación más frecuente(AU)

Medida da velocidade de condução nervosa motora em praticantes de três diferentes modalidades esportivas / Measurement of motor nerve conduction velocity in three different sports

INTRODUÇÃO: Estudos da condução nervosa têm sido focados para o público em geral, porém não para atletas, havendo carência de informações sobre medidas da velocidade de condução nervosa motora (VCNM) em indivíduos treinados, especialmente quando diferentes esportes são comparados. OBJETIVO: Medir a VCNM do nervo mediano e fibular comum, em três grupos de modalidades esportivas. Métodos: Foram analisados: um grupo de meio-fundistas (Gmf, n = 6), um grupo de velocistas (Gvel, n = 4) e um grupo de jogadores de handebol (Ghan, n = 5) e comparados com um grupo controle (Gcon, n = 9). Cada voluntário foi submetido a um único exame, no qual foram obtidos os dados para calcular a VCNM dos membros inferiores do Gmf e do Gvel, dos membros superiores do Ghan, e membros superiores e inferiores do Gcon. Os dados da pesquisa apresentaram distribuição normal e variâncias homogêneas, assim, utilizamos o teste t de Student para amostras independentes na comparação das médias da VCNM dos grupos de atletas com as do Gcon e as do Gvel com as do Gmf (comparações intergrupo). O teste t pareado foi usado para comparar as médias da VCNM entre membro dominante (Md) e membro não dominante (Mnd) (comparações intragrupo). RESULTADOS: Na análise intergrupo foram encontradas diferenças significativas nas comparações entre o Gvel e o Gcon e entre o Gmf e o Gcon (diferença apenas nas comparações entre os Md's). Por outro lado, a análise intragrupo, exibiu diferença significativa apenas nas comparações entre Md e Mnd do Ghan. CONCLUSÃO: O estudo sugere que a VCNM é beneficiada pelo esforço físico, principalmente em esportes com uso predominante dos membros inferiores, e que a maior utilização de um membro superior sobre outro pode levar a diferença significativa nos valores da VCNM do Md e Mnd.

INTRODUCTION: Electrodiagnostic tests such as nervous conduction studies are mainly aimed at the general public, not at athletes. Therefore, information about motor nervous conduction velocity (MNCV) is scarce for trained subjects, especially when different sports are compared. OBJECTIVE: to measure the MNCV of the median and common fibular nerves in three groups of sport modalities. Methods: A group of middle distance runners (M RG, n=6), a group of sprinter runners (S RG, n=4) and a group of handball players (H G, n=5) were analyzed and compared to a control group (C G, n=9). Each volunteer was submitted to a single examination where data necessary to measure MNCV from the lower limbs of M RG and of S RG; upper limbs of H G and both upper and lower limbs of C G were collected. Data analysis presented normal distribution and homogeneous variances in all cases; therefore, a Student's t test for independent samples was used to compare means of MNCV of the athlete groups and the C G, as well as in the mean comparison of S RG and M RG (intergroup comparison). The paired Student's t test was used to compare MNCV means of the dominant limb (DL) and non-dominant limb (NDL) (intragroup comparison). RESULTS: Significant differences were found in the comparison between S RG and CG and between M RG and CG, but only in the DL comparison in the last case. On the other hand, in the intragroup comparison, there was significant difference only in the comparison between D L and N DL of the H G. CONCLUSION: This study suggests that MNCV benefits from physical exercise, especially in those sports where lower limbs are predominantly used. It also suggests that greater use of one upper limb over the other could lead to significant differences in MNCV values of D L and N DL.