Geochemical behavior of rare earth elements (REE) in urban reservoirs: the case of Funil Reservoir, Rio de Janeiro State, Brazil.

Rare earth elements (REE) have unique chemical properties, which allow their use as geochemical tracers. In this context, the present study aims to assess the role of Funil Reservoir on REE biogeochemical behavior. We collected water samples upstream of the reservoir (P-01) in the city of Queluz, inside the reservoir (P-02), and downstream of Funil Reservoir (P-03) in the city of Itatiaia, RJ. In the field, physicochemical parameters were measured using a probe (pH, temperature, electrical conductivity, and dissolved oxygen). In the laboratory, water samples were filtered (0.45 µm) and properly packed until chemical analysis. Chlorophyll a concentrations were determined by a spectrophotometric method and suspended particulate matter (SPM) by a gravimetric method. Ionic concentrations were determined by ion chromatography technique and REE concentrations were determined by ICP-MS. Chlorophyll a concentrations were higher in Funil Reservoir. Ionic concentrations in Queluz (P-01) suggest anthropic contamination. The sum of REE in the dissolved fraction ranged from 2.12 to 12.22 µg L-1. A positive anomaly of La in Queluz indicates anthropic contamination. The observed patterns indicate that Funil Reservoir acts as a biogeochemical barrier, modifying the fluvial transport of REE. Nonetheless, another factor that probably influences REE behavior is the algal bloom that occurs in reservoirs during the rainy season. The seasonal behavior of algae can influence REE biogeochemistry through the incorporation and release of trace metals.

A straight choice: avoiding septal re-deviation using titanium plates. A 16 year retrospective patient follow-up evaluation.

BACKGROUND: To propose a new surgical technique for fixing the nasal septum to the midline, for long term prevention of nasal obstruction, in secondary and select cases of primary septoplasty. METHODOLOGY: Retrospective study, within hospital medical center. PATIENTS: Two hundred and twenty two patients who underwent septoplasty. Data collection occurred consecutively between March 1st of 2000 and May 1st 2016. Twenty six percent females and seventy four percent males. MAIN OUTCOME MEASURES: Patterns of septal deformity, materials used for titanium plates, surgical results, symptom improvement, and surgical complications were investigated. RESULTS: A total of 222 patients were included in this study. 163 patients (73%) had no previous nasal surgery. Fifty nine patients (27%) presented with a previous nasal surgery. Sixteen year follow up included more than 90% of patients and resulted in an overall 2.7% revision rate. CONCLUSIONS: The use of titanium plate for septoplasty has shown to be simple, safe, and easy to learn technique in both secondary and select cases of primary septoplasty. Most importantly the results indicate a long term prevention of the.

Effect of exercise while utilizing a device with an arm compression sleeve to reduce lymphedema.

BACKGROUND: Lymphedema is one complication of breast cancer treatment and there is no consensus that identified one single therapy in the treatment of lymphedema; therfore an association of methods is recommended and one of these is exercising. The aim of this study was to evaluate the utilization of exercising with a facilitating device along with an arm compression sleeve to reduce the size of lymphedematous arms. MATERIALS AND METHODS: Thirty women from a rehabilitation group with arm lymphedema resulting from the surgical, chemotherapeutic, and radiotherapeutic treatment of breast cancer were enrolled sequentially on arriving in the clinic. While sitting in an upright position and wearing an arm compression sleeve, patients were submitted to a one-hour session of active exercising consisting of four 12-minute stints with three-minute intervals to rest. The change in lymphedema was evaluated by water volumetry before and immediately after the session. The active exercising device is similar to the pedaling system of a bicycle. The paired t-test was employed for statistical analysis. An alpha error of 5% (p-value < 0.05) was considered acceptable. RESULTS: A statistically significant reduction (p-value < 0.004) was noted in the size of the arm. CONCLUSION: Active exercising using a facilitating device and under supervision may reduce the size of lymphedematous arms.

[Systolic pressure in wound scarring].

The recommended goal of a systolic pressure under 13 mmHg in hypertensive diabetic patients results in a significant drop in blood pressure that often has caused conflicts in respect to maintaining a minimum systolic pressure for wound scaring in patients with peripheral artery disease. This, as long as the patient remains asymptomatic, is no problem, however if the patient has a peripheral wound, the low systolic pressures may affect scarring.

Is the wearing of elastic stockings for half a day as effective as wearing them for the entire day?

Background There is good evidence for the use of compression for some clinical indications but little is known about dosimetry in compression. Objective The aim of this work was to evaluate whether or not the use of compression stockings during part of the day would help in the reduction of evening oedema in patients with clinical, epidemiological, anatomical and physiopathological (CEAP) classifications C0 and C1. Methods The effects of elastic compression stockings on volumetric variations during the working day were evaluated for the legs of two men and 18 women (40 legs). The inclusion criterion was classification as C0 (10 legs) or C1 (30 legs) according to the CEAP criteria. Participants used three-quarter-length elastic compression stockings (20-30 mmHg) on three consecutive days for the entire day or only for the morning or they did not use the stockings at all. Volumetry using the water displacement technique was performed in the morning and in the evening. When the patients wore the stockings only during the morning, volumetry was also performed at 13:00 h. Results Significant increases in volume were observed for both legs when stockings were not used compared with the use of stockings in the morning only. After removing the stockings, both legs had significant increases in volume in the afternoon. However, use for half the day was better than not using the stockings at all. Conclusions The use of elastic compression stockings can reduce volumetric variations during working hours, with the use of stockings for the entire day being better than for just half the day.

Clinical aspects of advanced stage lipo-lymphedema: case report.

The aim of the current study was to alert about dermatological alterations in the clinical evolution of lipo-lymphedema. The case of a 48-year-old patient is reported with clinical diagnosis of stage II lipo-lymphedema treated in the Angiology and Vascular Surgery Service of FAMERP. On physical examination the edema was hard, not reversible during rest, with nodules in the lower one-third of the limbs and a positive Stemmer's sign. The sizes of the nodules were different between legs. This report stresses the clinical findings and the differences in each disease. Additionally a review of publications is presented. The dermatological changes occurring in the evolution of lipedema may be associated with the evolution of lipo-lymphedema.

From radiometry to chronology of a marine sediment core: A 210Pb dating interlaboratory comparison exercise organised by the IAEA.

Laboratories from 14 countries (with different levels of expertise in radionuclide measurements and 210Pb dating) participated in an interlaboratory comparison exercise (ILC) related to the application of 210Pb sediment dating technique within the framework of the IAEA Coordinated Research Project. The laboratories were provided with samples from a composite sediment core and were required to provide massic activities of several radionuclides and an age versus depth model from the obtained results, using the most suitable 210Pb dating model. Massic concentrations of Zn and Cu were also determined to be used for chronology validation. The ILC results indicated good analytical performances while the dating results didn't demonstrate the same degree of competence in part due to the different experience in dating of the participant laboratories. The ILC exercise enabled evaluation of the difficulties faced by laboratories implementing 210Pb dating methods and identified some limitations in providing reliable chronologies.

Association of deep venous thrombosis with neoplasms in different age groups.

AIM: The objective of the current study was to evaluate if age is related to the prevalence of neoplasms in patients presenting with deep venous thrombosis. METHODS: The existence of neoplasms was investigated in 221 female and 194 male patients suffering from deep venous thrombosis. Their ages ranged from 11 to 92 years old with a mean of 55.2 years. Thoracic radiography, endoscopy, abdominal ultrasonography, computed tomography and magnetic resonance were requested in cases of clinically suspected neoplasms. The inclusion criterion was the presence of deep venous thrombosis and exclusion criterion was that the existence of neoplasms was not investigated. The patients were classified in age groups at 10-year intervals starting at the age of 40 years old. For statistical analysis the one sample t-test and Fisher exact test were utilized with an alpha-error of 5% considered acceptable. RESULTS: Neoplasms were detected in 3.4% of under 40-year-old patients, 5.6% between 40 and 50 years, 16.6% between 50 and 60 years, 26.8% between 60 and 70 years, 19.3% between 70 and 80 years and 10.8% in over 80-year-old. The association between neoplasms and age is significant for over 50-year-old when compared with those under 40-year-old (Fisher exact test P value <0.005) and there is a difference in percentages between the age groups (one sample t test P value=0.01). CONCLUSIONS: In conclusion the prevalence of neoplasms is associated to age with the highest rate in the 60- to 70-year age group.

Erysipelas and lymphangitis in patients undergoing lymphedema treatment after breast-cancer therapy.

AIM: The aim of this study was to evaluate the prevalence of erysipelas and lymphangitis in a group of patients under treatment for lymphedema after breast-cancer therapy. METHODS: A random observational prospective study of the incidences of lymphangitis and erysipelas was performed for 66 patients with arm lymphedema after breast-cancer treatment. The study was carried out between March 2006 and December 2007 at the Godoy Clinic in Sãoo José do Rio Preto, Brazil. The clinical evaluation of the participants was performed weekly before the start of treatment, with patients being required to immediately report any complications to the attending service. RESULTS: The mean time of follow-up of the patients between their treatment for breast cancer and the start of this study was 12.3 months, and three complications (4.5%) occurred; two cases of lymphangitis were reported after insect bites and one case of erysipelas after a hand injury, with repeat episodes reported by all three patients. CONCLUSION: In spite of prophylactic advice regarding lymphangitis and erysipelas during treatment for lymphedema after breast-cancer therapy, patients are subject to complications; however, this in itself does not justify the use of prophylactic antibiotic therapy.

Antibiogram in the biopsy of chronic venous ulcers related to sudden changes in the pain profile.

INTRODUCTION: Chronic venous insufficiency (CVI) has an important impact on the public health system in particular due to the occurrence of chronic venous ulcers (UCV) and infections. OBJECTIVE: To evaluate cultures of biopsies of chronic venous ulcers of patients who suffered an acute change in the intensity of pain of the lesion. METHOD: Antibiograms of the cultures of chronic venous ulcer biopsies of patients who suffered an acute change in the lesion with significant pain for 24 hours were evaluated. All patients were treated between 2011 and 2015 in the Vascular Surgery Outpatient Clinic of the Medical School in São José do Rio Preto. Other causes of pain such as chronic arterial insufficiency and problems with the dressings were ruled out. RESULTS: Positive cultures were detected in 34 of the 35 patients whose pain was resolved by antibiotic therapy. CONCLUSION: Acute changes in the intensity of pain associated with chronic venous ulcers seem to be related to local infectious disease.

Psychosocial effects of otoplasty in children with prominent ears.

This study aimed to investigate changes experienced by children during the pre- and postoperative periods of prominent ear corrective surgery. A total of 30 patients with prominent ears, sometimes called "lop ears" or "cup ears," ranging in age from 6 to 14 years were consecutively enrolled in this study. Half of the patients (n = 15, 50%) were male. The inclusion criteria specified children with prominent ears and reports of evident anatomic deformity. Clinical evaluations, routine laboratory tests, and interviews were performed in the pre- and postoperative periods. To assess the dissatisfaction or social maladjustment caused by the prominent ears, questionnaires, which are used routinely in psychological and psychiatric practices, were applied in the pre- and postoperative periods. The tests used were the Child Behavior Check List, the State-Trait Anxiety Inventory for Children, and the Children's Depression Inventory. The patients themselves and their parents or guardians reported improvements in terms of anatomic aspect. For the psychological tests, improvements in almost all the assessed items were observed. In conclusion, psychological problems caused by anatomic deformities, such as prominent ears, can be improved by adequate corrective surgery. Psychological support is necessary for the patients.

210Po concentration in Perna perna mussels: looking for radiation effects.

Twenty ropes with 400 Perna perna mussels seeds (3 cm shell size) were set-up on floating structures at Cabo Frio Island, Arraial do Cabo, approximately 100 km northeast of Rio de Janeiro city. A rope was taken out on a monthly basis, and the shell sizes of 100 seeds were measured. The haemolymph of 10 male and 10 female individuals was taken, and the same individuals were separated for 210Po/210Pb determination. After one year of monthly sampling, no clear correlation was observed between the 210Po concentration, mussel's age and weight. A mean 210Po concentration of 155 Bq kg(-1) wet weight basis, was obtained, which is comparable with data reported in the literature. The radiation dose did not have any observable effect on the micronuclei frequency and DNA breaks in the mussels. This was probably due to the low dose rate, 0.02 mGy d(-1), in comparison with the suggested potential dose limit of 10 mGy d(-1).

Sensitivity and specificity of combined perimetric and volumetric evaluations in the diagnosis of arm lymphedema.

The objective of the current study was to evaluate the sensitivity and the specificity of perimetry combined with volumetry in the treatment of lymphedema. Ninety women, who had been submitted to breast cancer surgery, were randomly selected in the Government Healthcare Clinic for this study. Only patients who underwent surgical treatment of breast cancer with some degree of lymphadenectomy were included in the study cohort. Individuals with active disease, whether local or otherwise, functional alterations of the upper limbs before breast cancer surgery were not included. The following possibilities were considered: 1--the perimetry evaluation was considered positive when the difference between the affected and unaffected sides was > or =2 cm for any one of the seven measurements and volumetry was > or = 100 mL; 2--perimetry > or =2 cm and volumetry > or =200 mL; 3--a difference > 10% between the two limbs in volumetry and perimetry. Prevalence, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were evaluated statistically with an alpha error of 5% considered acceptable (p-value < 0.05). The mean age of the women was 54.8 +/- 11.7 years. The sensitivity, negative predictive value and accuracy were higher using perimetry when a volume > or =2 cm were considered. The specificity and positive predictive values were better when the difference was greater than 10% between the two limbs by both perimetry and volumetry. Perimetry is a reliable method in the diagnosis of lymphedema when differences > or =2 cm between the two limbs should be considered.

Antiphospholipid antibodies and growth retardation in intrauterine development.

The aim of this study was to evaluate the efficacy of prophylaxis using low-dose non-fractioned heparin and aspirin in the prevention of intrauterine growth restriction and low birth weights in patients suffering from antiphospholipid antibody syndrome. Intrauterine growth retardation and birth weights of 34 gestations involving 28 women with histories of multiple miscarriages and elevated antiphospholipid antibody levels were evaluated in a prospective study in the period from April 1988 to July 2004. A control group was formed of 39 women without previous history of miscarriages over a total of 40 gestations. Intrauterine growth retardation was considered when the weight of the newborn baby was below the tenth percentile for gestational age according to the fetal weight chart. Diagnosis of antiphospholipid antibodies was achieved using the ELIZA test to measure the IgG and IgM immunoglobulin levels. Evaluation of lupus anticoagulant was performed using the activated partial thromboplastin time (aPTT). Women suffering from antiphospholipid antibodies underwent prophylactic treatment during gestation with low doses of acetylsalicylic acid (100 mg daily) associated to low doses of subcutaneous heparin (5000 IU twice daily). The non-paired Student t-test, Fisher Exact and Mann-Whitney tests were used for statistical analysis with an a error of up to 5% considered acceptable. A statistically higher number of newborns suffered intrauterine growth retardation and low birth weights in the study group than in the control group. In conclusion, children of mothers suffering from antiphospholipid antibody syndrome, even those undergoing prophylactic treatment with low-dose non-fractioned heparin and aspirin, are associated to intrauterine growth retardation and low birth weights.

Lower-extremity amputation: a 6-year follow-up study in Brazil.

PURPOSE: To evaluate the 6-year mortality in 50 patients following lower-limb amputation. METHODS: The cumulative survival rate of 50 (28 men, 22 women) amputees aged 54 to 94 years (mean, 67.3; median, 73.5) was retrospectively studied from 1993 to 1998. Indications for above- or below-knee amputation were trauma (n = 2), vasculitis (n = 2), and critical ischaemia of the lower limbs (n = 46). Leg amputation was performed after anamnesis, physical examination, and angiography. All patients were followed up for 6 years by phone or domiciliary visit. A death certificate was verified when a patient was lost to follow-up. Statistical analysis was expressed by the actuarial survival curve. RESULTS: Of 50 amputees, 36 died in the 6 years following leg amputation: 22 in the first year, 3 in the second year, 5 in the third year, 2 in the fourth year, 2 in the fifth year, 2 in the sixth year; 14 remained alive after 6 years. CONCLUSION: Patients who underwent lower-limb amputation had a high 6-year mortality. Most deaths occurred in the first year.

Factitious lymphedema of the arm: case report and review of publications.

The aim of this study was to report a case of factitious lymphedema of the arm and related lymphoscintigraphic aspects. The case of a 36-year-old patient is reported who started to present with pain, in the 3rd finger of the right hand three years prior to this report, which she associated with her work. Joint effusion was identified and treated using a splint that restricted blood flow leading to edema of the distal third of the forearm. Since then the patient was treated however her condition worsened resulting in edema of the entire arm. Subsequently she was referred to our service. A physical examination identified a restrictive band in the axillary region of the arm that delimited the edema. Volumetry and lymphoscintigraphic examinations of the limb were performed. The lymphoscintigraphy demonstrated acceleration of the flow in the affected limb and dermal reflux. Clinical treatment with removal of the restriction allowed a rapid reduction in the volume of the limb.

Prevalence of antithrombin deficiency in patients with chronic leg ulcer.

Antithrombin is one of the main endogenous anticoagulants and its deficiency is associated with deep venous thrombosis. The aim of the present study was to evaluate the prevalence of antithrombin deficiency in patients with chronic lower extremity ulcers. Forty-eight patients with chronic lower limb ulcers for longer than 10 years, evaluated during 1997, were studied: 40 were female (83.3%) and eight were male (16.6%), with ages ranging from 43 to 73 years (mean, 55.2 years). Antithrombin was dosed by the coagulometric method, with evaluation of the functional activity. Measurement was repeated in those cases where deficiency was found to be present. The highest prevalence rate for antithrombin deficiency in the general population was one in every 2000 cases. Data analysis was performed by utilizing the odds ratio with a confidence interval of 95% and P < 0.05. Deficiency in antithrombin levels was recorded in two (4.1%) of the patients with chronic ulcer. These results indicate a higher prevalence rate of antithrombin deficiency in those patients with chronic leg ulcers, suggesting that an association may be present. Further studies with a larger number of patients are required to confirm this hypothesis.

Evaluation of the 226Ra transport by river sediments surrounding the Brazilian uranium mining and milling facilities.

A study of the (226)Ra contamination of the river sediments surrounding the Brazilian uranium mining and milling facilities was carried out. The nondetrital (226)Ra concentrations were determined performing a 0.5 N HCl leaching. Some preliminary speciations experiments using Tessier's sequential extraction procedure were also carried out. (228)Ra was used as a monitor of the natural variations. In general one could not observe increase in the non-detrital (226)Ra fraction between the pre-operational and operational data. Additionally, speciations experiments have shown the exchangeable fraction to be the main one responsible for (226)Ra content. Although the results indicate that the sediment is an important means of radium downstream transport, its availability suggests the soluble form to be the main path through the main foodchain. Attention must be paid to the release of (226)Ra bound to barium sulphate from the chemical processing effluent since increments of that fraction were observed in bottom sediments.

Bilateral pulmonary artery aneurysm associated with bilateral pulmonary thromboembolism, superior vena caval thrombosis, and Chagas' disease--a case report.

The authors report a case of bilateral pulmonary artery aneurysm in a patient with chronic Chagas' disease and compensated congestive heart failure in whom clinical clues suggested pulmonary thromboembolism, and the actual nature of the lesions was discovered at the time of conventional imaging investigations. This case shows the rarity of bilateral pulmonary aneurysm associated with bilateral pulmonary thromboembolism and the importance of an awareness of this condition in the differential diagnosis for lung masses.