Liver transplantation and the use of KAVA: Case report.

BACKGROUND: Self-medication and the belief that herbal products are free of health risks are common in Brazil. The kava (Piper methysticum), known for its anxiolytic action, has a widespread popular use. Hepatotoxicity of kava is reported, including cases of liver transplantation and death. The kava had its use prohibited or restricted in countries like Germany, France, among others. Toxicity may be related to overdosage; however, factors such as botanical characteristics of the plant, the harvesting, storage, and production process may be associated with the development of hepatotoxic substances, such as triggering idiosyncratic reactions. HYPOTHESIS: In this case, there is a suspicion that the toxicide is intrinsic to the drug; however, the possibility of adulterants and contaminants must be ruled out. STUDY DESIGN: This study reports the case of a patient who, after using the herbal kava for 52 days, evolved into acute liver failure and liver transplantation. METHODS: The data were collected directly with the patient and compared with their clinical records. Causality was determined through the RUCAM algorithm. In addition, a phytochemical analysis of the drug used was performed. RESULTS: According to the patient's report, there is no evidence of overdosage. Results from RUCAM algorithm infer causality between liver damage and the use of kava. The analysis chemical constituents did not find any possible contaminants and major changes in the active compounds. Seven months after transplantation, the patient is well and continues to be followed up by a medical team. CONCLUSION: Our investigation indicates that there was kava-induced hepatotoxicity at standard dosages. In Brazil, self-medication by herbal medicines is frequent and many patients and health professionals do not know the risks associated with their use. Diagnosing and notifying cases in which plants and herbal medicine induce liver damage is of paramount importance to increase the knowledge about DILI and to prevent or treat similar cases quickly.

Postharvest UV-C irradiation stimulates the non-enzymatic and enzymatic antioxidant system of 'Isabel' hybrid grapes (Vitis labrusca×Vitis vinifera L.).

Ultraviolet light type C (UV-C) was studied as a tool to increase enzymatic and non-enzymatic antioxidant defenses and phytochemical levels in 'Isabel' grapes (Vitis labrusca×Vitis vinifera L.). Grapes were exposed to 0, 0.5, 1.0, 2.0, or 4.0kJm-2 UV-C and stored for 1, 3, or 5days post-treatment. One day after UV-C irradiation, the activities of grape antioxidant enzymes and thiols were increased, especially at 1.0 and 2.0kJm-2. These doses increased total phenolic content by almost 20%, while 0.5 and 4.0kJm-2 had no effects. Total monomeric anthocyanin content was increased by >35% by UV-C at 1.0kJm-2; however, anthocyanin profile was unchanged. Grape skin antioxidant capacity was also improved by UV-C irradiation. The 1.0kJm-2 UV-C was considered the hormetic dose. Postharvest UV-C had an elicitor effect on 'Isabel' grapes, positively impacting the antioxidant capacity and phytochemical content.

Human population and socioeconomic modulators of conservation performance in 788 Amazonian and Atlantic Forest reserves.

Protected areas form a quintessential component of the global strategy to perpetuate tropical biodiversity within relatively undisturbed wildlands, but they are becoming increasingly isolated by rapid agricultural encroachment. Here we consider a network of 788 forest protected areas (PAs) in the world's largest tropical country to examine the degree to which they remain intact, and their responses to multiple biophysical and socioeconomic variables potentially affecting natural habitat loss under varying contexts of rural development. PAs within the complex Brazilian National System of Conservation Units (SNUC) are broken down into two main classes-strictly protected and sustainable use. Collectively, these account for 22.6% of the forest biomes within Brazil's national territory, primarily within the Amazon and the Atlantic Forest, but are widely variable in size, ecoregional representation, management strategy, and the degree to which they are threatened by human activities both within and outside reserve boundaries. In particular, we examine the variation in habitat conversion rates in both strictly protected and sustainable use reserves as a function of the internal and external human population density, and levels of land-use revenue in adjacent human-dominated landscapes. Our results show that PAs surrounded by heavily settled agro-pastoral landscapes face much greater challenges in retaining their natural vegetation, and that strictly protected areas are considerably less degraded than sustainable use reserves, which can rival levels of habitat degradation within adjacent 10-km buffer areas outside.

Environmental Costs of Government-Sponsored Agrarian Settlements in Brazilian Amazonia.

Brazil has presided over the most comprehensive agrarian reform frontier colonization program on Earth, in which ~1.2 million settlers have been translocated by successive governments since the 1970's, mostly into forested hinterlands of Brazilian Amazonia. These settlements encompass 5.3% of this ~5 million km2 region, but have contributed with 13.5% of all land conversion into agropastoral land uses. The Brazilian Federal Agrarian Agency (INCRA) has repeatedly claimed that deforestation in these areas largely predates the sanctioned arrival of new settlers. Here, we quantify rates of natural vegetation conversion across 1911 agrarian settlements allocated to 568 Amazonian counties and compare fire incidence and deforestation rates before and after the official occupation of settlements by migrant farmers. The timing and spatial distribution of deforestation and fires in our analysis provides irrefutable chronological and spatially explicit evidence of agropastoral conversion both inside and immediately outside agrarian settlements over the last decade. Deforestation rates are strongly related to local human population density and road access to regional markets. Agrarian settlements consistently accelerated rates of deforestation and fires, compared to neighboring areas outside settlements, but within the same counties. Relocated smallholders allocated to forest areas undoubtedly operate as pivotal agents of deforestation, and most of the forest clearance occurs in the aftermath of government-induced migration.

Reconstrução anterior em resina composta associada a pino de fibra de vidro: relato de caso / Anterior tooth reconstruction with composite resin and fiber reinforced aesthetic pin: case report

A estética é uma preocupação do ser humano, tendo o sorriso nesse contexto um papel fundamental. O uso da faceta em resina composta está indicado para casos de grande perda de estrutura dentária vestibular. O objetivo deste trabalho é apresentar a confecção de faceta direta em resina composta no dente incisivo central superior direito (11) de um paciente com prejuízo estético e funcional. O trabalho salienta desde a urgência até a manutenção de saúde bucal, passando pelas fases de limpeza, cimentação do pino e construção da restauração, proporcionado por um tratamento integrado de diferentes especialidades.

Aesthetics are a concern of human beings with the smile in this context a crucial role. The use of facet composite resin is indicated for cases of severe loss of tooth structure entrance. The objective of this paper is to present the making of facet direct composite resin in upper right central incisor (11) of a patient with disfigurement and functional. The paper stresses the urgency since to maintaining oral health, through the stages of cleaning, cementing the pin and construction of restoration provided by an integrated treatment of different specialties.

Divergência de diagnóstico entre hígido, selamento biológico e cárie oclusal em esmalte ou esmalte e dentina, realizado por acadêmicos e cirurgiões-dentistas / Divergence between diagnostic healthy, biological sealing and occlusal caries in enamel or enamel and dentin, carried out by academics and dental professionals

Este trabalho se propôs analisar a divergência de diagnóstico e comparar os métodos de diagnóstico clínico e clínico associado ao radiográfico da cárie na região oclusal, em 15 dentes posteriores humanos, realizados por 07 cirurgiões dentistas e 14 acadêmicos de Odontologia. Os dentes foram montados em blocos de cera, radiografados de forma padronizada e submetidos à avaliação clínica e radiográfica da superfície oclusal, afirmando ou rejeitando a presença de cárie e sua extensão. Posteriormente, os dentes foram seccionados ao meio, no sentido mésio-distal, e então, analisados em macroscopia óptica para validação da presença de cárie e sua extensão, quando presente. A análise dos dados, utilizando o teste de Student- Newmam-Keuls através do pacote estatístico SPSS 8.0™, demonstrou não haver diferença estatística entre os métodos utilizados, sendo que o exame radiográfico pouco contribuiu para a detecção de cárie oclusal. O índice de acerto, tanto para profissionais, quanto para acadêmicos foi maior no exame clínico que o radiográfico e as divergências de diagnósticos foram razoáveis.

This study proposed to analyze the difference and compare the diagnostic methods and clinical diagnosis associated with radiographic caries on the occlusal surfaces of 15 human posterior teeth, performed by 07 dentists and 14 dental students. The teeth were mounted in wax blocks, radiographed in a standardized manner and underwent clinical and radiographic evaluation of the occlusal surface, affirming or rejecting the presence of caries and its extension. Subsequently the teeth were bisected in the mesiodistal direction, and then analyzed to validate the macroscopic optical caries and its extension when present. The data analysis by test student-Neuwman-Keuls showed no statistical difference between the methods used when radiographic examination contributed little to the detection of occlusal caries. The hit rate for both professionals and for academics was higher in the clinical examination and radiographic diagnoses of divergence were reasonable.