Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy. Influence of pylorus preservation procedure

PURPOSE: To evaluate the nutritional status of patients in the late postoperative period of pancreaticoduodenectomy (PD) and compare the long-term outcome according to pylorus-preserving (PPPD) or the standard technique (SPD) in which the pylorus is resected. METHODS: This prospective study was conducted twelve months prior or more in patients who had underwent PD (PD Group, n=15) and health volunteers (Control Group, n=15). At a post hoc analysis, the PD Group was divided in PPPD Subgroup (n=9) and SPD Subgroup (n=6), according to the PD techniques. Gastrointestinal complaints and nutritional status were evaluated, apart from a biochemical assessment; Student t-test or Mann-Whitney test were used. RESULTS: The patients recovered their body weight and the gastrointestinal complaints were uncommon. The PD Group showed higher energy and protein intake even though BMI was lower than in Control Group. There were no differences in laboratorial data, except for higher glycemia, serum alkaline phosfatase and C-reactive protein in PD Group. There was no difference in the various parameters evaluated when the Subgroups (PPPD and SPD) were compared. CONCLUSION: For long-term pancreaticoduodenectomy, the gastrointestinal symptoms are minimal and the patients had the clinical and nutritional status preserved, regardless of pylorus preservation.

Discovery of hearing impairment by the family: seeing an idealized future collapse

OBJECTIVE: To portray the family experience when the discovery of hearing impairment in their child. METHODS: Qualitative research with Symbolic Interactionism and Grounded Theory as theoretical and methodological frameworks. Data collection instrument: semi-structured interview. The study included nine families (32 participants). RESULTS: The theme, "Seeing an idealized future collapse", shows that for the family, discovered the possibility of having a child with hearing loss is a moment that involves many negative feelings. CONCLUSION: Discover the hearing loss has a meaning of the expected loss of the perfect child, frustrated expectations and uncertain future. The family has been inadequately approached and the diagnosis has been made late, which requires immediate changes to the practices of professionals.

LIZARDS AND SNAKES (LEPIDOSAURIA, SQUAMATA) FROM THE LATE QUATERNARY OF THE STATE OF CEARA IN NORTHEASTERN BRAZIL

We present the first formal report on the squamate assemblage from Parque Nacional de Ubajara. This park contains the most important cave complex in the state of Ceara in northeastern Brazil, called Provincia Espeleologica de Ubajara. The material comes from the Urso Fossil cave at Pendurado Hill. All previously reported fossil remains found in this cave are tentatively attributed to the Quaternary (late Pleistocene-early Holocene). Probably only Arctotherium brasiliense represents a relictual fossil bear from the late Pleistocene megafauna. The taxa recognized in this paper belong to Tropidurus sp., Ameiva sp., cf. Epicrates, and cf. Crotalus durissus, adding to the knowledge of the Brazilian Quaternary squamate fauna as a whole, and contribute to a major taxonomic refinement of the squamate assemblages from the early Holocene of northeastern Brazil.

Late evaluation of the relationship between morphological and functional renal changes and hypertension after non-operative treatment of high-grade renal injuries

Objective: To evaluate the anatomical and functional renal alterations and the association with post-traumatic arterial hypertension. Methods: The studied population included patients who sustained high grades renal injury (grades III to V) successfully non-operative management after staging by computed tomography over a 16-year period. Beyond the review of medical records, these patients were invited to the following protocol: clinical and laboratory evaluation, abdominal computed tomography, magnetic resonance angiography, DMSA renal scintigraphy, and ambulatory blood pressure monitoring. The hypertensive patients also were submitted to dynamic renal scintigraphy (Tc-99m EC), using captopril stimulation to verify renal vascular etiology. Results: Of the 31 patients, there were thirteen grade III, sixteen grade IV (nine lacerations, and seven vascular lesions), and two grade V injuries. All the patients were asymptomatic and an average follow up post-injury of 6.4 years. None had abnormal BUN or seric creatinine. The percentage of renal volume reduction correlates with the severity as defined by OIS. There was no evidence of renal artery stenosis in Magnetic Resonance angiography (MRA). DMSA scanning demonstrated a decline in percentage of total renal function corresponding to injury severity (42.2 +/- 5.5% for grade III, 35.3 +/- 12.8% for grade IV, 13.5 +/- 19.1 for grade V). Six patients (19.4%) had severe compromised function (< 30%). There was statistically significant difference in the decrease in renal function between parenchymal and vascular causes for grade IV injuries (p < 0.001). The 24-hour ambulatory blood pressure monitoring detected nine patients (29%) with post-traumatic hypertension. All the patients were male, mean 35.6 years, 77.8 % had a familial history of arterial hypertension, 66.7% had grade III renal injury, and average post-injury time was 7.8 years. Seven patients had negative captopril renography. Conclusions: Late results of renal function after conservative treatment of high grades renal injuries are favorable, except for patients with grades IV with vascular injuries and grade V renal injuries. Moreover, arterial hypertension does not correlate with the grade of renal injury or reduction of renal function.

The discovery of male Potiicoara brasiliensis (Crustacea, Spelaeogriphacea) with notes on biology and distribution

The male of Potiicoara brasiliensis is reported for the first time with evidence of sexual dimorphism. Male diagnostic characters are described and compared with the other three species of Spelaeogriphidae. Males present differential morphology on both distal podomere articles of the antennula and antenna, an elongate and curved bare endopod on pleopod 2, a pair of short round penes on the sternum near the base of pereopod 7, and telson with dorsum almost smooth and apex straight. Material is sampled for the first time from karstic areas north of the species type-locality, Gruta Ricardo Franco near Corumba City, and Gruta do Curupira in the Araras Mountains. These new findings expand the distribution of the species over seven hundred kilometers. Comparisons between exemplars of both sexes are presented. A hypothesis on the distributional pattern of P. brasiliensis is introduced based on the geological history of Central-West Brazil.

OXYGEN ABUNDANCES IN LOW- AND HIGH-alpha FIELD HALO STARS AND THE DISCOVERY OF TWO FIELD STARS BORN IN GLOBULAR CLUSTERS

Oxygen abundances of 67 dwarf stars in the metallicity range -1.6 < [Fe/H] < -0.4 are derived from a non-LTE analysis of the 777 nm O I triplet lines. These stars have precise atmospheric parameters measured by Nissen and Schuster, who find that they separate into three groups based on their kinematics and alpha-element (Mg, Si, Ca, Ti) abundances: thick disk, high-alpha halo, and low-alpha halo. We find the oxygen abundance trends of thick-disk and high-alpha halo stars very similar. The low-alpha stars show a larger star-to-star scatter in [O/Fe] at a given [Fe/H] and have systematically lower oxygen abundances compared to the other two groups. Thus, we find the behavior of oxygen abundances in these groups of stars similar to that of the a elements. We use previously published oxygen abundance data of disk and very metal-poor halo stars to present an overall view (-2.3 < [Fe/H] < +0.3) of oxygen abundance trends of stars in the solar neighborhood. Two field halo dwarf stars stand out in their O and Na abundances. Both G53-41 and G150-40 have very low oxygen and very high sodium abundances, which are key signatures of the abundance anomalies observed in globular cluster (GC) stars. Therefore, they are likely field halo stars born in GCs. If true, we estimate that at least 3% +/- 2% of the local field metal-poor star population was born in GCs.

THE GEMINI NICI PLANET-FINDING CAMPAIGN: DISCOVERY OF A MULTIPLE SYSTEM ORBITING THE YOUNG A STAR HD 1160

We report the discovery of two low-mass companions to the young A0V star HD 1160 at projected separations of 81 +/- 5 AU (HD 1160 B) and 533 +/- 25 AU (HD 1160 C) by the Gemini NICI Planet-Finding Campaign. Very Large Telescope images of the system taken over a decade for the purpose of using HD 1160 A as a photometric calibrator confirm that both companions are physically associated. By comparing the system to members of young moving groups and open clusters with well-established ages, we estimate an age of 50(-40)(+50) Myr for HD 1160 ABC. While the UVW motion of the system does not match any known moving group, the small magnitude of the space velocity is consistent with youth. Near-IR spectroscopy shows HD 1160 C to be an M3.5 +/- 0.5 star with an estimated mass of 0.22(-0.04)(+0.03) M-circle dot, while NIR photometry of HD 1160 B suggests a brown dwarf with a mass of 33(-9)(+12) M-Jup. The very small mass ratio (0.014) between the A and B components of the system is rare for A star binaries, and would represent a planetary-mass companion were HD 1160 A to be slightly less massive than the Sun.

Discovery of the Persistent Luminescence Mechanism of CdSiO3:Tb3+

The persistent luminescence of CdSiO3:Tb3+ was investigated with photoluminescence, thermoluminescence (TL), synchrotron radiation X-ray absorption (XANES and EXAFS) and UV-VUV spectroscopies. Only the typical intraconfigurational 4f(8)-4f(8) transitions of the Tb3+ ion were observed with no traces of band emission in either the conventional UV excited or persistent luminescence spectra. The trap structure from TL with three traps from 0.65 to 0.85 eV is ideal for room-temperature persistent luminescence similar to, e.g., Sr2MgSi2O7:Eu2+,R3+. Despite the rather low band gap energy, 5.28 eV, the persistent luminescence from Tb3+ is produced only under UV irradiation due to the inauspicious position of the F-7(6) ground level deep in the band gap of CdSiO3. This confirms the role of electrons as the charge carriers in the mechanism of Tb3+ persistent luminescence. The XANES spectra indicated the presence of only the trivalent Tb3+ species, thus excluding the direct Tb3+ -> Tb-IV oxidation during the charging process of persistent luminescence. Eventually, a unique persistent luminescence mechanism for Tb3+ in CdSiO3 was constructed based on the comprehensive experimental data.

Dental caries-related quality of life and socioeconomic status of preschool children, Bauru, SP

AIM: To evaluate oral health-related quality of life of preschool children of Bauru, State of São Paulo, Brazil, and associate it with socioeconomic profile of households. METHODS: The sample consisted of 229 preschool children between 3 and 5 years and the dmft (decayed, missing due to caries, filled teeth) index was adopted for assessment children's dental caries in accordance with the standards recommended by the World Health Organization. Questionnaires were used for evaluation oral health-related quality of life (Early Childhood Oral Health Impact Scale) and socioeconomic profile of parents or guardians of the preschool children. Statistical analysis was performed descriptively by relative and absolute frequencies and by Spearman's correlation and Kruskal-Wallis test (p <0.05). RESULTS: A dmft of 1.65 (± 2.87) and a Sic Index 4.88 (± 3.20) were found, indicating the polarization of dental caries in the studied group. It was verified low influence of oral health on quality of life of the children examined. With respect to socioeconomic classification, 66.38% of families were in the lower middle class. Linear and statistically significant correlation was found between dmft and oral health-related quality of life for the overall score and domains of the questionnaire (p<0.001). CONCLUSIONS: It was found low influence of oral health on quality of life of the preschool children and the assessment of socioeconomic conditions of the children's families may guide practices aiming to reducing inequalities in the distribution of dental caries in the population.

Correlates of change in self-perceived oral health among older adults in Brazil Findings from the Health, Well-Being and Aging Study

Background. Identifying changes in the oral health status of older populations, and their predictors and explanations, is necessary for public health planning. The authors assessed patterns of change in oral health-related quality of life in a large cohort of older adults in Brazil during a five-year period and evaluated associations between baseline characteristics and those changes. Methods. The sample consisted of 747 older people enrolled in a Brazilian cohort study called the Health, Well-Being and Aging (Saude, Bem-estar e Envelhecimento [SABE]) Study. Trained examiners measured participants' self-perceived oral health by using the General Oral Health Assessment Index (GOHAI). The authors calculated changes in the overall GOHAI score and in the scores for each of the GOHAI's three dimensions individually by subtracting the baseline score from the score at follow-up. A positive difference indicated improvement in oral health, a negative difference indicated a decline and a difference of zero indicated no change. Results. The authors found that 48.56 percent of the participants experienced a decline in oral health and 33.48 percent experienced an improvement. Participants with 16 or more missing teeth and eight or more years of education were more likely to have an improvement in total GOHAI score. Deterioration was more likely to occur among those with two or more diseases. Improvement and decline in GOHAI functional scores were related to the number of missing teeth. The authors found no significant model for the change in the psychosocial score, and Self-rated general health was the only variable related to both improvement and decline in pain or discomfort scores. Conclusions. The authors observed a bidirectional change in self-perceived oral health, with deterioration predominating. The strongest predictor of improvement in the total GOHAI score was the number of missing teeth, whereas the number of diseases was the strongest predictor of deterioration. Clinical Implications. Dental professionals and policymakers need to know the directions of change in older adults' oral health to establish treatment priorities and evaluate the impact of services directed at this population.