Maxillary artery utilization in subcranial-intracranial bypass procedures: a comprehensive systematic review and pooled analysis.

The utilization of the internal maxillary artery (IMAX) in subcranial-intracranial bypass for revascularization in complex aneurysms, tumors, or refractory ischemia shows promise. However, robust evidence concerning its outcomes is lacking. Hence, the authors embarked on a systematic review with pooled analysis to elucidate the efficacy of this approach. We systematically searched PubMed, Embase, and Web of Science databases following PRISMA guidelines. Included articles used the IMAX as a donor vessel for revascularizing an intracranial area and reported at least one of the following outcomes: patency, complications, or clinical data. Favorable outcomes were defined as the absence of neurologic deficits or improvement in the baseline condition. Complications were considered any adverse event directly related to the procedure. Out of 418 retrieved articles, 26 were included, involving 183 patients. Among them, 119 had aneurysms, 41 experienced ischemic strokes (transient or not), 2 had arterial occlusions, and 3 had neoplasia. Furthermore, 91.8% of bypasses used radial artery grafts, and 87.9% revascularized the middle cerebral artery territory. The median average follow-up period was 12 months (0.3-53.1). The post-operation patency rate was 99% (95% CI: 97-100%; I2=0%), while the patency rate at follow-up was 82% (95% CI: 68-96%; I2=77%). Complications occurred in 21% of cases (95% CI: 9-32%; I2=58%), with no significant procedure-related mortality in 0% (95% CI: 0-2%; I2=0%). Favorable outcomes were observed in 88% of patients (95% CI: 81-96%; I2=0%), and only 3% experienced ischemia (95% CI: 0-6%; I2=0%). The subcranial-intracranial bypass with the IMAX shows excellent postoperative patency and considerable favorable clinical outcomes. While complications exist, the procedure carries a minimal risk of mortality. However, long-term patency presents heterogeneous findings, warranting additional research.

STA-MCA Double-Barrel Bypass: A Systematic Review of Technique and Single-Arm Meta-Analysis of Outcomes.

INTRODUCTION: Conventionally, one branch of the superficial temporal artery (STA) is utilized to revascularize the middle cerebral artery (MCA). However, there is the possibility of utilizing both branches of the STA when performing the bypass, characterizing the double-barrel (DB) STA-MCA bypass. Notably, a lack of studies evaluating this technique led the authors to conduct a systematic review and single-arm meta-analysis. METHODS: PubMed, Embase and Web of Science were searched systematically for publications of DB-STA-MCA bypass on November 1st, 2023. The findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Case reports were not included for statistical analysis purposes. RESULTS: The review included 408 patients and 534 bypasses from 34 studies. The main etiology was Moyamoya disease (64.6%), followed by cerebral ischemia (22.2%) and aneurysms (12.5%). The median of the mean follow-ups of each study was 12.8 months (range 1.5-87.9). The postoperative patency was 100%. The follow-up patency was 98% (95% CI: 96%-100%; I2 = 0%). The procedure-related mortality was 0% (95% CI: 0%-1%; I2 = 0%). Aneurysms obtained 87% (95% CI: 72%-100%; I2 = 4%) of good clinical outcomes, while Moyamoya disease yielded a rate of 70% (95% CI: 10%-100%; I2 = 97%). Ischemic complications occurred at a rate of 6% (95% CI: 2%-11%; I2 = 36%), while hemorrhagic occurred at 6% (95% CI: 1%-11%; I2 = 56%). Hyperperfusion syndrome rate was calculated as 18% (7%-30%; I2 = 55%) for Moyamoya disease. CONCLUSIONS: The procedure appears to be safe, with excellent patency rates. The clinical efficacy for ischemic and Moyamoya diseases warrants further standardized robust investigation with a broader number of patients, and aneurysm studies are required to enhance sample sizes. The main complication for the Moyamoya subgroup is hyperperfusion syndrome.

An electricity market-based approach to finance environmental flow restoration.

As environmental flow demands become better characterized, improved water allocation and reservoir operating solutions can be devised to meet them. However, significant economic trade-offs are still expected, especially in hydropower-dominated basins. This study explores the use of the electricity market as both an institutional arrangement and an alternative financing source to handle the costs of implementing environmental flows in river systems managed for hydropower benefits. A framework is proposed to identify hydropower plants with sustainable operation within the portfolio of power sources, including a cost-sharing mechanism based on the electricity market trading to manage a time-step compensation fund. The objective is to address a common limitation in the implementation of environmental flows by reducing the dependence on government funding and the necessity for new arrangements. Compensation amounts can vary depending on ecosystem restoration goals (level of flow regime restoration), hydrological conditions, and hydropower sites characteristics. The application in the Paraná River Basin, Brazil, shows basin-wide compensation requirements ranging from zero in favorable hydrological years to thousands of dollars per gigawatt-hour generated in others. Each electricity consumer's contribution to the compensation fund is determined by their share of energy consumption, resulting in values ranging from cents for residential users to thousands of dollars for industrial facilities. Finally, the compensation fund signals the economic value of externalities in energy production. For residential users, achieving varying levels of ecosystem restoration led to an electricity bill increase of less than 1 %. For larger companies, the increase ranged from less than 1 %-12 %.

Validity and Usability of a New System for Measuring and Monitoring Variations in Vertical Jump Performance.

Loturco, I, Pereira, LA, Kobal, R, Kitamura, K, Cal Abad, CC, Marques, G, Guerriero, A, Moraes, JE, and Nakamura, FY. Validity and usability of a new system for measuring and monitoring variations in vertical jump performance. J Strength Cond Res 31(9): 2579-2585, 2017-Vertical jump (VJ) height is one of the most sensitive measures to quantify training-related fatigue and athletic performance in elite athletes. Currently, however, there is no equipment designed to graphically deliver the daily performance changes in VJ compared with the smallest worthwhile change (SWC), which is considered essential in "progressive statistics" to judge meaningful performance fluctuations. The aims of the study were to analyze the criterion validity of a new contact mat (i.e., Elite Jump), alongside testing its usability to detect meaningful changes in VJ of elite team sport athletes. A total of 31 athletes participated in the criterion validity part of the study, whereas 17 rugby players participated in the VJ sensitivity part. When compared with the force plate, the contact mat produced squat jump (SJ) and countermovement jump (CMJ) values with very high intraclass correlation coefficients (0.998 and 0.997, respectively) and very low biases (-0.11 and -0.08 cm, respectively), as assessed by the Bland-Altman plot. In addition, during a training microcycle, rugby players presented identical meaningful changes in performance in both SJ and CMJ when comparing the Elite Jump and Hopkins' spreadsheet outputs. Therefore, the contact mat is valid and the proprietary software can properly execute the SWC calculations, providing coaches and researchers with accurate information concerning variations in the physical performance of elite athletes.

Light-emitting diode therapy (LEDT) before matches prevents increase in creatine kinase with a light dose response in volleyball players.

Low-level laser (light) therapy (LLLT) has been applied over skeletal muscles before intense exercise (muscular pre-conditioning) in order to reduce fatigue and muscle damage (measured by creatine kinase, CK) in clinical trials. However, previous exercise protocols do not exactly simulate the real muscle demand required in sports. For this reason, the aim of this randomized and double-blind placebo-controlled trial was to investigate whether light-emitting diode therapy (LEDT) applied over the quadriceps femoris muscles, hamstrings, and triceps surae of volleyball players before official matches could prevent muscle damage (CK) with a dose response, establishing a therapeutic window. A professional male volleyball team (12 athletes) was enrolled in this study, and LEDT was applied before 4 matches during a national championship. LEDT used an array of 200 light-emitting diodes (LEDs) arranged in 25 clusters of 4 infrared LEDs (850 ± 20 nm; 130 mW) and 25 clusters of 4 red LEDs (630 ± 10 nm; 80 mW). Athletes were randomized to receive one of four different total doses over each muscle group in a double-blind protocol: 105 J (20 s), 210 J (40 s), 315 J (60 s), and placebo (no light for 30 s). CK in blood was assessed 1 h before and 24 h after each match. LEDT at 210 J avoided significant increases in CK (+10 %; P = 0.993) as well as 315 J (+31 %, P = 0.407). Placebo (0 J) allowed a significant increase in CK (+53 %; P = 0.012) as well as LEDT at 105 J (+59 %; P = 0.001). LEDT prevented significant increases of CK in blood in athletes when applied before official matches with a light dose response of 210-315 J, suggesting athletes might consider applying LEDT before competition.

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas.

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production-from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Surgical management of retinal detachment and macular holes secondary to ocular toxoplasmosis: a systematic review and meta-analysis.

BACKGROUND: Toxoplasma gondii causes ocular toxoplasmosis (OT), involving inflammation, scarring, and retinal complications. The OT complications were retinal detachment (RD), and retinal breakage (RB). Surgical interventions like scleral buckling (SB) and vitrectomy are common. Limited understanding exists of the safety and efficacy of surgical management of RD/RB secondary to OT. Another complication is toxoplasmosis-related macular holes (tMH), with sparse evidence on surgical outcomes. This meta-analysis aims to clarify clinical characteristics, and surgical results, and enhance understanding of RD, RB, and MH secondary to OT. METHODS: PubMed, Cochrane, Embase and Web of Science database were queried for retrospective studies, case series and case reports that provided information on RD, RB and MH associated with OT and reported the outcomes of: (1) Retinal reattachment of RD/RB and tMH closure; (2) Best-corrected visual acuity (BCVA) improvement; and (3) Complications. Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity. Statistical analysis was performed using the software R (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria). RESULTS: Fourteen final studies, comprising a total of 96 patients were analyzed, 81 with RD or RB and 15 with tMH. Overall, surgical management was associated with several advantages: a high rate of retinal reattachment of RD/RB of 97% (95% Confidence Interval [CI] 92-100%; I2 = 0%), retinal reattachment of just RD of 96% (95% CI 89-100%; I2 = 30%) and tMH closure 97% (95% CI 87-100; I2 = 12%). There were significant differences in BCVA after surgeries in studies of RD/RB (MD 0.60; 95% CI 0.35-0.65; I2 = 20%) and MH (MD 0.67; 95% CI 0.50-0.84; I2 = 0%). The overall complication rate associated with surgical procedures in RD/RB secondary to OT was confirmed to be 25%. CONCLUSIONS: The systematic review and meta-analysis showed that the treatment approaches currently in use are effective, with a remarkable rate of retinal reattachment of RD/RB, tMH closure, and substantial improvements in visual acuity. More randomized, long-term studies on disease and surgical factors can provide valuable insights into their impact on anatomical and visual outcomes.

Comparing surgical clipping with endovascular treatment for unruptured middle cerebral artery aneurysms: a systematic review and updated meta-analysis.

OBJECTIVE: Unruptured middle cerebral artery aneurysm (uMCAA) has traditionally been treated with open surgical clipping (SC). Endovascular treatments (EVTs) were designed to reduce surgical risks in these cases. Nevertheless, despite its potential benefits, many surgeons favor SC for uMCAA. This updated meta-analysis aimed to compare the safety, efficacy, and clinical outcomes of SC and EVT for uMCAA. METHODS: The authors searched the Medline, Embase, and Cochrane Library databases according to the Cochrane and PRISMA guidelines. Eligible studies included those with ≥ 4 patients with uMCAA reporting comparative data of SC and EVT. The endpoints were the complete occlusion rate (Raymond class I and II), good clinical outcomes (modified Rankin Scale score ≤ 2 or Glasgow Outcome Scale score ≥ 4), procedure-related complications (further divided into major and minor), and mortality. The authors pooled OR with 95% CI values with a random-effects model. I2 statistics were used to assess heterogeneity, and sensitivity analysis was conducted to address high heterogeneity. Publication bias was assessed with funnel plot analysis and the Egger's test. RESULTS: The analysis included data from 10 studies. Regarding the complete occlusion assessment, the comparative analysis revealed OR 0.17 (95% CI 0.08-0.40, p < 0.01), favoring SC. In terms of achieving good clinical outcomes, OR 0.44 (95% CI 0.20-0.97, p < 0.05) was determined, favoring SC. No differences regarding total procedure-related complications, major complications, or mortality were identified. However, a higher likelihood of minor complications was identified for EVT, with OR 4.68 (95% CI 2.01-10.92, p < 0.01). CONCLUSIONS: This systematic review and meta-analysis identified a lower likelihood of complete occlusion at last follow-up and lower likelihood of good clinical outcomes in patients treated with EVT when compared with SC. Furthermore, a higher likelihood of minor complications was identified in patients who underwent EVT when compared with SC. The findings reinforce that, based on the currently available data, SC should be considered the primary approach for treating uMCAA. However, EVT is an evolving approach, and this study's findings represent a synthesis of observational studies. Randomized trials are warranted to elucidate which approach should be the mainstay for uMCAA and to identify the nuances that determine whether SC or EVT is more or less indicated for addressing uMCAA with consideration of the individuality of each patient and aneurysm.

Immigration in Brazilian medical and psychiatric discourse in the post-Second World War period. / A imigração no discurso médico-psiquiátrico brasileiro no pós-Segunda Guerra Mundial.

The article analyzes the contributions of psychiatry to the debate on health and immigration in the post-Second World War, when Brazil received war refugees and displaced persons from Eastern Europe. The concern with mental disorders attributed to war traumas made mental health a topic of debate in the specialized press. From the analysis of medical articles published in the journals Arquivos Brasileiros de Higiene Mental and Arquivos Brasileiros de Neuriatria e Psiquiatria and in Revista de Imigração e Colonização, we seek to understand the relevance of immigration as a field in which psychiatrists took action and vied for legitimacy as authorities in the preparation of Brazil's immigration policies.

O artigo analisa as contribuições da psiquiatria no debate sobre saúde e imigração no período pós-Segunda Guerra Mundial, quando o Brasil recebeu refugiados e deslocados de guerra vindos do Leste Europeu. A preocupação com desordens mentais atribuídas aos traumas de guerra tornava a saúde mental tema de debate na imprensa especializada. A partir da análise de artigos médicos publicados nas revistas Arquivos Brasileiros de Higiene Mental e Arquivos Brasileiros de Neuriatria e Psiquiatria e na Revista de Imigração e Colonização , busca-se compreender a relevância da imigração como um campo de atuação e disputa por legitimidade dos psiquiatras no papel de autoridades na elaboração das políticas imigratórias brasileiras.

RELATIONSHIP BETWEEN PARVOVIRUS B19 AND OSTEOARTHRITIS: LITERATURE REVIEW.

Osteoarthritis and Parvovirus B19 infection present silent and gradual evolution, since the former is a degenerative process while the latter is often asymptomatic and may persist in the individual's body during their life. This study aims to analyze clinical studies that establish a correlation between degenerative osteoarthritis and Parvovirus B19 infection. Of the 62 studies found, 25 were chosen for reading in full. Analyzing only the studies that establish the correlation between the pathologies, seven confirm this relationship between Parvovirus B19 and Osteoarthritis, while one reports no relationship. No objective correlation could be found between the other articles studied. Our findings suggest that there is a close relationship between Parvovirus B19 and Osteoarthritis, with a higher prevalence of acquired causes, women and older adults, but it can manifest during life. However, it is essential to carry out new studies involving family history of patients with Osteoarthritis with positivity of Parvovirus B19, cohort studies between childhood and adult-old adult, so that it can elucidate this duality of congenital-acquired cause and, finally, raise treatment alternatives. Level of Evidence II, Systematic Review of Level II Studies.

Tanto a osteoartrite quanto a infecção pelo parvovírus B19 apresentam evolução muitas vezes silenciosa e gradual, uma vez que a primeira é um processo degenerativo, e a segunda é geralmente assintomática, podendo persistir no corpo do indivíduo por toda a sua vida. Esta revisão bibliográfica visa analisar estudos clínicos que estabeleceram a correlação entre a osteoartrite degenerativa e a infecção pelo parvovírus B19. Dos 62 artigos encontrados, foram eleitos 25 para leitura em sua totalidade. Analisando apenas os artigos que estabelecem a relação entre as patologias, temos sete que confirmaram essa relação, enquanto um deles afirmou que não há relação. Não houve correlação objetiva entre os demais artigos estudados. Nossos resultados sugerem que há estreita relação entre a osteoartrite e o parvovírus B19, que tende a ser uma doença de causa adquirida com maior prevalência em mulheres e idosos, porém que pode se manifestar durante toda a vida. Contudo, é crucial a realização de novos estudos envolvendo antecedentes familiares de pacientes com osteoartrite e com positividade para o parvovírus B19 e estudos de coorte entre a infância e o adulto-idoso, a fim de elucidar essa dualidade de causa congênita-adquirida e, enfim, levantar alternativas de tratamento. Nível de Evidência II, Revisão Sistemática de Estudos de Nível II.

Stromal Vascular Fraction for Knee Osteoarthritis - An Update.

Orthobiologics never cease to cause popularity within the medical science field, distinctly in regenerative medicine. Recently, adipose tissue has been an object of interest for many researchers and medical experts due to the fact that it represents a novel and potential cell source for tissue engineering and regenerative medicine purposes. Stromal vascular fraction (SVF), for instance, which is an adipose tissue-derivative, has generated optimistic results in many scenarios. Its biological potential can be harnessed and administered into injured tissues, particularly areas in which standard healing is disrupted. This is a typical feature of osteoarthritis (OA), a common degenerative joint disease which is outlined by persistent inflammation and destruction of surrounding tissues. SVF is known to carry a large amount of stem and progenitor cells, which are able to perform self-renewal, differentiation, and proliferation. Furthermore, they also secrete several cytokines and several growth factors, effectively sustaining immune modulatory effects and halting the escalated pro-inflammatory status of OA. Although SVF has shown interesting results throughout the medical community, additional research is still highly desirable in order to further elucidate its potential regarding musculoskeletal disorders, especially OA.

[Risk model to assess livestock rabies exposure in the state of São Paulo, Brazil]. / Modelo de risco para circulação do vírus da raiva em herbívoros no estado de São Paulo, Brasil.

OBJECTIVE: To propose a qualitative risk assessment model for the study of livestock exposure to rabies virus from the vampire bat Desmodus rotundus (antigenic variant 3) in the Paraíba do Sul river valley, state of São Paulo, Brazil. METHODS: Based on scenario trees generated considering rabies exposure and its spread, we estimated the probability of rabies cases in large livestock and its association with the geographic location of livestock farms. RESULTS: Assessment of the historical series of rabies focal points in the first semester of 2006, which was used to validate the risk assessment model, revealed that 81.8% of the focal points were adequately foreseen by the model and could have been prevented with strategic vaccination in high-risk areas. CONCLUSIONS: The adoption of control measures specifically targeting high-risk areas might entail a substantial decrease in the number of rabies focal points, at a low cost and with optimal movement of field teams.

A giant hand lipoma as a rare cause of secondary carpal tunnel syndrome - A case report.

INTRODUCTION: Lipomas are a rare cause of compressive neuropathy and they lead to atypical clinical presentation that can mimic carpal tunnel syndrome. CASE PRESENTATION: The authors describe a rare presentation of a carpal tunnel syndrome recurrence after a hand giant lipoma, presenting with rapidly compression neuropathy of the median nerve, 6 months after de primary surgery. DISCUSSION: Lipomas are common benign soft tumours. Their occurrence in the hand remains rare and they rarely cause secondary entrapment neuropathies. Carpal tunnel syndrome is mostly idiopathic and bilateral. Local factors should be suspected when these neuropathies present with atypical symptomatology or even when they recur after primary conventional surgical release. Investigation should consider images studies as this correct preoperative assessment leads to successful diagnosis and treatment.

Systematic monitoring of glanders-infected horses by complement fixation test, bacterial isolation, and PCR.

Glanders is an equine zoonosis caused by Burkholderia mallei that is responsible for considerable economic loss. Complement fixation testing (CFT) using warm or cold incubation are recommended by the OIE, but many routinely used detection tests may present misleading results. To increase accuracy of glanders diagnosis and establish an appropriate protocol in collaboration with the National Equine Health Program, seven horses positive for glanders kept in isolation in Brazil were examined fortnightly by CFT, microbiological screening, and molecular testing. Warm and cold serologies with USDA and c.c.Pro antigens, respectively, were performed on 132 samples using the US Department of Agriculture protocol. The warm and cold serologies showed, respectively,12.9% and 17.3% seroreactive, 85.7% and 65.2% non-reactive, 0.8% and 3% inconclusive, and 0% and 2.3% anticomplementary. The agreement of CFT protocols was moderate. Of 213 clinical samples submitted to selective culture (167 nasal swabs, 5 ocular swabs, 3 lymph node punctures, and 38 tissue samples from four horses that died), 1.9% tested positive for B. mallei. Fourteen samples and one nasal swab (7%) tested positive with PCR. Cold CFT with the USDA and c.c.Pro antigens, in combination with PCR to increase sensitivity, may be useful for diagnosis of chronic glanders.

Relationship between parvovirus b19 and osteoarthritis: literature review / Relação entre parvovírus b19 e osteoartrite: revisão bibliográfica

ABSTRACT Osteoarthritis and Parvovirus B19 infection present silent and gradual evolution, since the former is a degenerative process while the latter is often asymptomatic and may persist in the individual's body during their life. This study aims to analyze clinical studies that establish a correlation between degenerative osteoarthritis and Parvovirus B19 infection. Of the 62 studies found, 25 were chosen for reading in full. Analyzing only the studies that establish the correlation between the pathologies, seven confirm this relationship between Parvovirus B19 and Osteoarthritis, while one reports no relationship. No objective correlation could be found between the other articles studied. Our findings suggest that there is a close relationship between Parvovirus B19 and Osteoarthritis, with a higher prevalence of acquired causes, women and older adults, but it can manifest during life. However, it is essential to carry out new studies involving family history of patients with Osteoarthritis with positivity of Parvovirus B19, cohort studies between childhood and adult-old adult, so that it can elucidate this duality of congenital-acquired cause and, finally, raise treatment alternatives. Level of Evidence II, Systematic Review of Level II Studies.

RESUMO Tanto a osteoartrite quanto a infecção pelo parvovírus B19 apresentam evolução muitas vezes silenciosa e gradual, uma vez que a primeira é um processo degenerativo, e a segunda é geralmente assintomática, podendo persistir no corpo do indivíduo por toda a sua vida. Esta revisão bibliográfica visa analisar estudos clínicos que estabeleceram a correlação entre a osteoartrite degenerativa e a infecção pelo parvovírus B19. Dos 62 artigos encontrados, foram eleitos 25 para leitura em sua totalidade. Analisando apenas os artigos que estabelecem a relação entre as patologias, temos sete que confirmaram essa relação, enquanto um deles afirmou que não há relação. Não houve correlação objetiva entre os demais artigos estudados. Nossos resultados sugerem que há estreita relação entre a osteoartrite e o parvovírus B19, que tende a ser uma doença de causa adquirida com maior prevalência em mulheres e idosos, porém que pode se manifestar durante toda a vida. Contudo, é crucial a realização de novos estudos envolvendo antecedentes familiares de pacientes com osteoartrite e com positividade para o parvovírus B19 e estudos de coorte entre a infância e o adulto-idoso, a fim de elucidar essa dualidade de causa congênita-adquirida e, enfim, levantar alternativas de tratamento. Nível de Evidência II, Revisão Sistemática de Estudos de Nível II.

A imigração no discurso médico-psiquiátrico brasileiro no pós-Segunda Guerra Mundial / Immigration in Brazilian medical and psychiatric discourse in the post-Second World War period

Resumo O artigo analisa as contribuições da psiquiatria no debate sobre saúde e imigração no período pós-Segunda Guerra Mundial, quando o Brasil recebeu refugiados e deslocados de guerra vindos do Leste Europeu. A preocupação com desordens mentais atribuídas aos traumas de guerra tornava a saúde mental tema de debate na imprensa especializada. A partir da análise de artigos médicos publicados nas revistas Arquivos Brasileiros de Higiene Mental e Arquivos Brasileiros de Neuriatria e Psiquiatria e na Revista de Imigração e Colonização , busca-se compreender a relevância da imigração como um campo de atuação e disputa por legitimidade dos psiquiatras no papel de autoridades na elaboração das políticas imigratórias brasileiras.

Abstract The article analyzes the contributions of psychiatry to the debate on health and immigration in the post-Second World War, when Brazil received war refugees and displaced persons from Eastern Europe. The concern with mental disorders attributed to war traumas made mental health a topic of debate in the specialized press. From the analysis of medical articles published in the journals Arquivos Brasileiros de Higiene Mental and Arquivos Brasileiros de Neuriatria e Psiquiatria and in Revista de Imigração e Colonização, we seek to understand the relevance of immigration as a field in which psychiatrists took action and vied for legitimacy as authorities in the preparation of Brazil's immigration policies.

Anesthesia for pulmonary trunk aneurysmorrhaphy.

BACKGROUND AND OBJECTIVES: The aneurysm in the pulmonary trunk is a rare disease. Because of its location, a rupture can lead to right ventricular failure and sudden death. Aneurysmorraphy is the most widely used surgical treatment in these cases. The aim of this study is to report a successful balanced general anesthesia for aneurysmorraphy of pulmonary trunk. CASE REPORT: Male patient, 28 years, asymptomatic, diagnosed with an aneurysm in the pulmonary trunk. According to the location of the aneurysm and the consequent failure of the pulmonary valve, an aneurysmorraphy was indicated, with implantation of vascular-valvular prosthesis (valved tube). We opted for a balanced general anesthesia, seeking to prevent an increase in systemic and pulmonary vascular resistances, thus avoiding to cause stress on the wall of the aneurysmal vessel. CONCLUSIONS: A balanced general anesthesia, in combination with adequate ventilation to prevent elevation in pulmonary vascular pressure, was appropriate for surgical repair of an aneurysm in the pulmonary trunk.

[Anesthesia for pulmonary trunk aneurysmorrhaphy]. / Anestesia para aneurismorrafia de tronco de artéria pulmonar.

BACKGROUND AND OBJECTIVES: The aneurysm in the pulmonary trunk is a rare disease. Because of its location, a rupture can lead to right ventricular failure and sudden death. Aneurysmorraphy is the most widely used surgical treatment in these cases. The aim of this study is to report a successful balanced general anesthesia for aneurysmorraphy of pulmonary trunk. CASE REPORT: Male patient, 28 years, asymptomatic, diagnosed with an aneurysm in the pulmonary trunk. According to the location of the aneurysm and the consequent failure of the pulmonary valve, an aneurysmorraphy was indicated, with implantation of vascular-valvular prosthesis (valved tube). We opted for a balanced general anesthesia, seeking to prevent an increase in systemic and pulmonary vascular resistances, thus avoiding to cause stress on the wall of the aneurysmal vessel. CONCLUSIONS: A balanced general anesthesia, in combination with adequate ventilation to prevent elevation in pulmonary vascular pressure, was appropriate for surgical repair of an aneurysm in the pulmonary trunk.

Clinical and radiographic medium-term evaluation on patients with developmental dysplasia of the hip, who were submitted to open reduction, capsuloplasty and Salter osteotomy.

OBJECTIVE: to evaluate the clinical and radiographic medium-term results from surgical treatment of developmental dysplasia through open reduction, Salter et al.'s osteotomy and capsuloplasty. METHODS: 13 patients were evaluated, 13 hips treated surgically by the proposed technique between 2004 and 2011. A clinical and radiographic evaluation was conducted by Dutoit et al. and Severin et al. criteria, respectively. RESULTS: the acetabular preoperative index for the 13 surgically treated hips ranged from 27° to 50° (average of 36), and after surgical correction to 18.5° (10-28°), so that the evaluations of preoperative and postoperative acetabular indexes showed up significant statistic reduction (p < 0.05). Regarding the postoperative clinical evaluation, it was found: nine excellent hips (69.2%), three good ones (23.1%), no fair hips (0%) and a poor one (7.7%). In radiographic evaluation, it was found: six excellent hips (46.1%), three good ones (23.1%), no fair hips (0%) and four poor ones (30.8%). Therefore, favorable results were obtained (92.3%), with grouped hips with excellent and good ratings as satisfactory and with fair and bad ratings as unsatisfactory. It is also important to notice that there was no significance among occurrence of complications, the patient's age, the time of surgery and the preoperative acetabular index (p > 0.05). As complications occurred, it was found that three subluxations and a subluxation associated with avascular necrosis of the femoral head. CONCLUSION: open reduction, Salter et al.'s osteotomy and capsuloplasty are seen to be a viable option for the treatment of developmental dysplasia of the hip, according to clinical and radiological medium-term evaluations.

OBJETIVO: avaliar o resultado clínico e radiológico do tratamento cirúrgico da displasia do desenvolvimento do quadril em médio prazo, por meio da redução aberta, da capsuloplastia e da osteotomia de Salter et al. MÉTODOS: foram avaliados 13 pacientes, 13 quadris, entre 2004 e 2011, tratados cirurgicamente pela técnica proposta. Uma avaliação clínica e radiológica foi feita pelos critérios de Dutoit et al. e Severin et al., respectivamente. RESULTADOS: nos 13 quadris acometidos o índice acetabular pré­operatório variou de 27° a 50° (média de 36) e, após correção cirúrgica, para 18,5° em média, com variação de 10° a 28°, de modo que as avaliações dos índices acetabulares pré e pós­operatórios apresentaram redução com significância estatística (p < 0,05). Quanto à avaliação clínica pós­operatória, foram encontrados: nove quadris ótimos (69,2%), três bons (23,1%), nenhum regular (0%) e um ruim (7,7%). Na avaliação radiológica, foram encontrados seis quadris ótimos (46,1%), três bons (23,1%), nenhum regular (0%) e quatro ruins (30,8%). Portanto, obtiveram­se resultados favoráveis em 92,3%, pois agrupam­se quadris com avaliação ótima e boa como satisfatórios e os com avaliação regular e ruim como insatisfatórios. Atente­se que não houve significância entre a ocorrência de complicações, a idade do paciente, o momento da cirurgia e o índice acetabular pré­operatório (p > 0,05). Como complicações ocorridas, têm­se três subluxações isoladas e uma subluxação associada à necrose avascular da cabeça femoral. CONCLUSÃO: a redução aberta, a capsuloplastia e a osteotomia de Salter et al. são consideradas uma opção viável do ponto de vista clínico e radiológico em médio prazo para o tratamento da displasia do desenvolvimento do quadril.