Treatment of primary spontaneous pneumothorax by videothoracoscopic talc pleurodesis under local anesthesia: a review of 133 procedures.

AIM: To review our experience of treatment of primary spontaneous pneumothorax by videothoracoscopic talc pleurodesis. METHODS: From 2000 to 2008, 124 consecutive patients with primary spontaneous pneumothorax were operated; 105 were men (84.7%) and 19 were women (15.3%) with a mean age of 26.6 years (range 17-46 years). RESULTS: No mortality was recorded. Staging according to Vanderschueren's classification was as follows: stage I, 61 patients (45.9%); stage II, 39 patients (29.3%); stage III, 31 patients (23.3%); stage IV, two patients (1.5%). The overall rate of complications was 9% (12/133), corresponding to prolonged air leak in 9(6.7%) patients and hemothorax in 3(2.2%) patients. Four patients (3%) had recurrence requiring reoperation. There were no episodes of acute respiratory failure, pneumonia or subcutaneous emphysema following talc pleurodesis. CONCLUSIONS: Thoracoscopic pleural talc pleurodesis as a treatment for recurrent pneumothorax is easy, safe, and rapid, and causes minimal morbidity and mortality.

The influence of education in the validation process of a food frequency questionnaire for adults in Viçosa, Minas Gerais, Brazil.

OBJECTIVE: To evaluate the educational influence in the relative validation of a semiquantitative food frequency questionnaire (FFQs) for adults in the city of Viçosa, Brazil. DESIGN AND SUBJECTS: Four 24-h dietary recalls (reference method) were applied to a sample of 94 adults of both genders, at intervals of 1 month. At the end of the study, an FFQs consisting of 58 food items was also applied. Then, the individuals were divided into two main groups according to their educational level (lower and higher). The dietary data were calculated by the Diet Pro 4.0 software and analyzed according to differences of means or medians and Pearson's correlation coefficients. These coefficients were adjusted by the energy and corrected by the within-person variance for each educational group, considering the extreme quartiles of the data distribution. RESULTS: The intake of energy and nutrients, based on the 24 h dietary recalls, was inferior for the lower educational group (P < 0.05). For the FFQs, just the protein and calcium intakes were statistically different, suggesting interference of the education variable in this assessment. Over estimations in the FFQs were identified in the analyses of means and medians for vitamin C and retinol intakes in the lower education group and for retinol in the higher education one. However, when evaluated by correlation coefficients non-adjusted and adjusted, they were well correlated. On the other hand, lipid (r = 0.34) and calcium (r = 0.13) coefficients of the group with less instruction showed beneath the desirable values, suggesting weak consistence of the estimates provided by the FFQs for these nutrients. Correlation means of r = 0.65 and 0.54 were found for the higher and lower educational groups, respectively. CONCLUSIONS: The results indicate that FFQs showed acceptable performance on evaluating the habitual food consumption for most of the nutrients in the studied population. A tendency for better quantifications in the groups with higher education was observed, inferring its influence in the assessment of the dietary intake.

[Primary malignant melanoma of the esophagus]. / Melanoma maligno primario de esófago.

Primary malignant melanoma of the esophagus is very rare, and only 139 cases have been described in all the world literature. We present one case of primary malignant melanoma of the esophagus in a 76-year-old woman who reported the symptoms of dysphagia and recent weight loss; the radiography showed a large polypoid mass filling the entire lower half of the esophagus, dark brown-black in the endoscopy. Histologic analysis demonstrated the existence of a malignant melanoma infiltrating the esophageal mucosa, composed of anaplastic cells with abundant brown pigment which had positive immunoreactivity for the S-100 protein.

[Agglutinating and immobilizing activity of an ethanol extract of Bursera fagaroides on human and other mammalian spermatozoa]. / Actividad aglutinante e inmovilizante del extracto etanólico de Bursera fagaroides sobre espermatozoides de humano y de otros mamíferos.

Human spermatozoa and those obtained from mouse epididymis incubated in ethanolic from mouse epididymis incubated in ethanolic extracts of the cortex of Bursera fagaroides became agglutinated and immobilized in 100% with 30% of viability decrease. This double effect occurred in 50% of pig'ssperm and 50% of rabbit sperm when the concentration was increased tenfold. The pattern of progressive motility was affected 80% of rat's spermatocytes without agglutination. The values remained the same when the extracts were partially purified with salts of Zn++ and Ba++ or by filtration in a sephadex g-10 column. Analysis with thin layer chromatography of both purified extracts produced 3 compounds in comparison with the ethanolic unpurified extract. The extract of the plant Bursera fagaroides contains 3 compounds, which apparently are glycosides with a potent activity upon agglutination -immobilization and a low effect upon spermatocytes viability, which might be used as contraceptives .