Total gastric transposition is better than partial gastric tube esophagoplasty for esophageal replacement in children

Whenever the surgeon uses the stomach as an esophageal substitute, either one of two techniques is generally performed: total gastric transposition or gastric tube esophagoplasty. No existing reports compare the complications associated with these two surgical procedures. The purpose of this study is to review the authors` experience with total gastric transposition and verify whether this technique is superior to gastric tube esophagoplasty in children by comparing the main complications with those reported in the publications of gastric tubes esophagoplasties in the English language literature published in the last 38 years. A total of 35 children underwent total gastric transposition according to the classical technique. Most of these patients (27, or 77.1%) had long gap esophageal atresia. The most frequently observed complications were compared to those reported in nine studies of gastric tube esophagoplasty comprising 184 patients. Mortality and graft failure rates were also compared. Seven patients (20.0%) presented with leaks, all of which closed spontaneously. Six children were reoperated, three experienced gastric outlet obstruction secondary to axial torsion of the stomach placed in the retrosternal space and the other three experienced delayed gastric emptying that required revision of the piloroplasty. There were two deaths (5.7%) and no graft failure. Strictures were observed in five patients (14.2%) and all of these were resolved with endoscopic dilatations. Six patients had diarrhea that spontaneously resolved. In the late follow-up period, all patients were on full feed and thriving well. The comparisons with gastric tube patients demonstrated that the total gastric transposition group presented with significantly less leaks and strictures (P = 0.0001 and 0.001, respectively). The incidence of death and graft failure was not statistically different. In conclusion, gastric transposition is as a simple technical procedure for esophageal replacement in children with satisfactory results, and is superior to gastric tube esophagoplasty.

Accuracy of intraoperative cultures in primary total hip arthroplasty

The aim of this investigation was to assess the diagnostic accuracy of intraoperative cultures for the early identification of patients who are at risk of infection after primary total hip arthroplasty. Four or six swabs were obtained immediately before the wound closure in 263 primary total hip replacements. Patients with a maximum of one positive culture were denoted as patients with a normal profile and did not receive any treatment. Patients with two or more positive cultures, with the same organism identified, were denoted as patients with a risk profile and received treatment with a specific antibiotic as determined by the antibiogram for six weeks. The follow-up ranged from a minimum of one year to five years and eleven months, concentrating on the presence or absence of infection, which was defined as discharge of pus through the surgical wound or as a fistula at any time after surgery. The accuracy of this procedure ( number of cases correctly identified in relation to the total number of cases) in the group of 152 arthroplasties in which 4 swabs per patient were collected was 96%. In the group of 111 arthroplasties in which 6 swabs per patient were collected the accuracy was 95.5%. We conclude that the collection of swabs under the conditions described is a method of high accuracy ( above 95%) for the evaluation of risk of infection after primary total hip arthroplasty.

Assessment of trace elements in fishes of Japanese foods marketed in Sao Paulo (Brazil)

In recent years, there has been increasing fish consumption in Brazil, largely due to the popularity of Japanese cuisine. No study, however, has previously assessed the presence of inorganic contaminants in species used in the preparation of Japanese food. In this paper, we determined total arsenic, cadmium, chromium, total mercury, and lead contents in 82 fish samples of Tuna (Thunnus thynnus), Porgy (Pagrus pagrus), Snook (Centropomus sp.), and Salmon (Salmo salar) species marketed in Sao Paulo (Brazil). Samples were mineralized in HNO(3)/H(2)O(2) for As, Cd, Cr and Pb, and in HNO(3)/H(2)SO(4)/V(2)O(5) for Hg. Inorganic contaminants were determined after the validation of the methodology using Inductively Coupled Plasma Optical Emission Spectrometry (ICP OES); and for Hg, an ICP-coupled hydride generator was used. Concentration ranges for elements analyzed in mg kg(-1) (wet base) were as follows: Total As (0.11-10.82); Cd (0.005-0.047); Cr (0.008-0.259); Pb (0.026-0.481); and total Hg (0.0077-0.9681). As and Cr levels exceeded the maximum limits allowed by the Brazilian law (1 and 0.1 mg kg(-1)) in 51.2 and 7.3% of the total samples studied, respectively. The most contaminated species were porgy (As = 95% and Cr = 10%) and tuna (As 91% and Cr = 10%). An estimation of As, Cd, Pb, and Hg weekly intake was calculated considering a 60 kg adult person and a 350 g consumption of fish per week, with As and Hg elements presenting the highest contribution on diets reaching 222% of provisional tolerable weekly intake (PTWI) for As in porgy and 41% of PTWI for Hg in tuna. (C) 2010 Elsevier Ltd. All rights reserved.

Comparison of ketamine and S(+)-ketamine, with romifidine and diazepam, for total intravenous anesthesia in horses

Objective To compare the quality of induction and recovery, degree of muscle relaxation, clinically apparent potency and cardiopulmonary effects of racemic ketamine or S(+)-ketamine when used for total intravenous anesthesia in horses. Study design Prospective randomized clinical trial Animals Sixteen healthy stallions (323 +/- 99 kg), with a mean age of 6.2 years, undergoing castration. Methods Horses were pre-medicated with romifidine IV, 15 minutes before induction of anesthesia. Each animal was then randomly allocated to receive either diazepam and ketamine (DK) or diazepam and S(+)-ketamine (DKS) at similar doses to induce anesthesia. For maintenance of anesthesia, 1/4 of the initial bolus of ketamine alone or S(+)-ketamine alone was administered, as required. Heart rate (HR), respiratory rate (RR) and systolic blood pressure were measured before and at 10-minute intervals during recumbency. Time from induction to lateral recumbency, time from induction to first additional dose, time from last additional dose to return to sternal posture and time from last additional dose to standing were recorded, and a subjective evaluation of quality of induction, endotracheal intubation, muscle relaxation and quality of recovery was recorded. Results The quality of the induction and duration of anesthesia were similar in both groups. HR, RR and systolic blood pressure were not significantly different between groups. Although some animals which received DKS showed some minor excitatory effects (25% of them) during the induction of anesthesia, these animals received 32% fewer doses for the maintenance of anesthesia and the recovery scores were better. Conclusions and clinical relevance S(+)-ketamine showed some advantages over racemic ketamine, such as less anesthetic agent being required and better overall recovery from anesthesia. Further studies are needed to obtain the optimum induction dose for the S(+)-ketamine.

Polymerization stress, shrinkage and elastic modulus of current low-shrinkage restorative composites

Objective. To compare currently available low-shrinkage composites with others regarding polymerization stress, volumetric shrinkage (total and post-gel), shrinkage rate and elastic modulus. Methods. Seven BisGMA-based composites (Durafill/DU, Filtek Z250/FZ, Heliomolar/HM, Aelite LS Posterior/AP, Point 4/P4, Filtek Supreme/SU, ELS/EL), a silorane-based (Filtek LS, LS), a urethane-based (Venus Diamond, VD) and one based on a dimethacrylate-derivative of dimer acid (N`Durance, ND) were tested. Polymerization stress was determined in 1-mm high specimens inserted between two PMMA rods attached to a universal testing machine. Total volumetric shrinkage was measured using a mercury dilatometer. Maximum shrinkage rate was used as a parameter of the reaction speed. Post-gel shrinkage was measured using strain-gages. Elastic modulus was obtained by three-point bending. Data were submitted to one-way ANOVA/Tukey test (p = 0.05), except for elastic modulus (Kruskal-Wallis). Results. Composites ranked differently for total and post-gel shrinkage. Among the materials considered as ""low-shrinkage"" by the respective manufacturers, LS, EL and VD presented low post-gel shrinkage, while AP and ND presented relatively high values. Polymerization stress showed a strong correlation with post-gel shrinkage except for LS, which presented high stress. Elastic modulus and shrinkage rate showed weak relationships with polymerization stress. Significance. Not all low-shrinkage composites demonstrated reduced polymerization shrinkage. Also, in order to effectively reduce polymerization stress, a low post-gel shrinkage must be associated to a relatively low elastic modulus. (C) 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Effect of oxalate desensitizers and dentin moisture during total-etch bonding

Purpose: To evaluate the effect of oxalate during total-etch bonding, under different dentin moisture conditions, over time. The null hypothesis tested was that microtensile bond strength (mu TBS) was not affected by oxalate treatment and dentin moisture during two evaluation periods. Methods: Extracted human third molars had their mid-coronal dentin exposed flat and polished with 600-grit SiC paper. The surfaces were etched with 35% phosphoric acid for 15 seconds, washed and blot dried. After etching, a 3% potassium oxalate gel was applied for 120 seconds, except for the control group (no desensitizer). The surface was then washed and left moist (Wet bonding) or air-dried for 30 seconds (Dry bonding). The surfaces were bonded with: (I) two 2-step etch-and-rinse adhesives: Single Bond (SB); Prime & Bond NT (PBNT) and (2) one 3-step etch-and-rinse adhesive: Scotchbond Multi Purpose (SBMP). Composite buildups were constructed incrementally with Tetric Ceram resin composite. Each increment was cured for 40 seconds. After storage in water for 24 hours or 1 year at 37 C, the specimens were prepared for mu TBS testing with a cross-sectional area of approximately 1 mm(2). They were then tested in tension in an Instron machine at 0.5 mm/minute. Data were analyzed by ANOVA and Student-Newman-Keuls at alpha = 0.05. Results: Application of potassium oxalate had no significant effect on the bond strengths of SBMP and PBNT, regardless of the surface moisture condition (P > 0.05). Conversely, reduced bond strengths were observed after oxalate treatment for SB in both moisture conditions, that being significantly lower when using a dry-bonding procedure (P < 0.05). Lower bond strength was obtained for PBNT when a dry-bonding technique was used, regardless of the oxalate treatment (P < 0.05). After aging the specimens for 1 year, bond strengths decreased. Smaller reductions were observed for SBMP, regardless of moisture conditions. For the WB technique, smaller reductions after 1 year were observed without oxalate treatment for SB and after oxalate treatment for PBNT. (Am J Dent 2010;23:137-141).

Dietary predictors of serum total carotene in low-income women living in Sao Paulo, south-east Brazil

Objective Dietary intake and nutritional status of antioxidant vitamins have been reported to protect against some cancers The objective of the present study was to assess the correlations between serum levels of carotenoids (including beta-, alpha- and gamma-carotene), lycopene, retinol, alpha- and gamma-tocopherols, and dietary intakes estimated by an FFQ, among low-income women in the Brazilian Investigation into Nutrition and Cervical Cancer Prevention (BRINCA) study. Design Cross-sectional study of data for 918 women aged 21-65 years participating in the BRINCA study in Sao Paulo city. Multiple linear regression models were used with serum nutrient levels as the dependent variable and dietary intake levels as the independent variable, adjusted for confounding factors. Results In energy-adjusted analyses, the intakes of dark green and deep yellow vegetables and fruits (partial R(2) = 4.8%), total fruits and juices (partial R(2) = 1.8%), vegetables and fruits (partial R(2) = 1.8%), carrots (partial R(2) = 1.4%) and citrus fruits and juices only (partial R(2) = 0.8%) were positively correlated only with serum total carotene levels, after adjusting for serum total cholesterol concentration, age, hospital attended, smoking status. BMI and presence of cervical lesions Multiple-adjusted serum levels of carotenoids were positively correlated with intake quartiles of dark green and deep yellow vegetables and fruits and total fruits and juices independent of smoking status. Conclusions The intake of specific fruits and vegetables was an independent predictor of serum total carotene levels in low-income women living in Sao Paulo

Effects of Mate Tea (Ilex paraguariensis) Ingestion on mRNA Expression of Antioxidant Enzymes, Lipid Peroxidation, and Total Antioxidant Status in Healthy Young Women

The antioxidant activity of mate tea, the roasted product derived from yerba mate (Ilex paraguarienis), was observed in vitro and in animal models, but studies in humans are lacking. The aim of this study was to investigate the effects of mate tea supplementation on plasma susceptibility to oxidation and on antioxidant enzyme gene expression in healthy nonsmoking women, after acute or prolonged ingestion. We evaluated plasma total antioxidant status (TAS), the kinetics of diene conjugate generation, and thiobarbituric acid reactive substance (TBARS) contents in plasma, as well as mRNA levels of antioxidant gluthatione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT). After the supplementation period with mate tea, lipid peroxidation was acutely lowered, an effect that was maintained after prolonged administration. Total antioxidant status and the level of antioxidant enzyme gene expression were also demonstrated after prolonged consumption. These results suggest that regular consumption of mate tea may increase antioxidant defense of the body by multiple mechanisms.

Analysis of total visual and CCD V-broadband observations of Comet C/1995 O1 (Hale-Bopp): 1995-2001

We developed a general method for determination of water production rates from groundbased visual observations and applied it to Comet Hale-Bopp. Our main objective is to extend the method to include total visual magnitude observations obtained with CCD detector and V filter in the analysis of total visual magnitudes. We compare the CCD V-broadband careful observations of Liller [Liller, W. Pre-perihelion CCD photometry of Comet 1995 01 (Hale-Bopp). Planet. Space Sci. 45, 1505-1513, 1997; Liller, W. CCD photometry of Comet C/1995 O1 (Hale-Bopp): 1995-2000. Int. Comet Quart. 23(3), 93-97, 2001] with the total visual magnitude observations from experienced international observers found in the International Comet Quarterly (ICQ) archive. A data set of similar to 400 CCD observations covering about the same 6 years time span of the similar to 12,000 ICQ selected total visual magnitude observations were used in the analysis. A least-square method applied to the water production rates, yields power laws as a function of the heliocentric distances for the pre- and post-perihelion phases. The average dimension of the nucleus as well as its effective active area is determined and compared with values published in the literature. (C) 2009 COSPAR. Published by Elsevier Ltd. All rights reserved.

Phylogeny of the Neotropical genus Acestrorhynchus (Ostariophysi: Characiformes) based on nuclear and mitochondrial gene sequences and morphology: A total evidence approach

Acestrorhynchus is the sole genus of the family Acestrorhynchidae which includes 14 species currently recognized as valid. Species of Acestrorhynchus comprise small-to-medium sized piscivorous fishes and have been traditionally grouped on the basis of well-defined color patterns. A recent phylogeny, based on morphological characters, could not resolve the phylogenetic affinities of A. heterolepis and the relationships among the species of the clade formed by A. abbreviatus, A. altus, A. falcatus, A. lacustris, and A. pantaneiro. The simultaneous analysis of two mitochondrial genes (16S and ATP synthase subunits 6 and 8) and one nuclear intron (S7) was able to resolve the latter clade, but the position of A. heterolepis remained unresolved. The combination of the molecular and morphological data sets in a total evidence analysis resulted in a well-resolved hypothesis regarding the phylogenetic relationships of Acestrorhynchus species. (C) 2009 Elsevier Inc. All rights reserved.

Taxon surrogates among Amazonian mammals: Can total species richness be predicted by single orders?

Limited financial sources and the difficulty in performing complete surveys, allied to the speed of habitat fragmentation and the urgent necessity in select conservation areas, create the necessity of using some methodologies which bypass these problems. One possibility is the use of surrogate taxa that might be used as indicator of others groups richness and even total richness of an area. We investigated if the use of surrogate taxon is useful among seven mammal orders in Amazon. We tested through Pearson`s correlation (Bonferroni`s adjusted) if (1) there was a correlation between richness of total species and some order; (2) there was a significant pair wise correlation between species richness of each order; and (3) the combination of two orders would give better results as a surrogate for the total richness. The correlations found, in general, were positive. It means that the increase in the richness of an order was followed by its increase in another order, as well as in the total species richness. Only Didelphimorphia was significantly correlated with the total species richness. In the pair wise analyses only one assembly, Primates and Artiodactyla, was significantly correlated with total richness. Since indicator species are more effective within taxonomic groups (life-history characteristics are likely to be more different among than within major taxonomic groups), we suggest that an indicator group might be chosen for each one. In this case, for mammals from Amazon, it would be Didelphimorphia. (C) 2008 Elsevier Ltd. All rights reserved.

Total absolute horospherical curvature of submanifolds in hyperbolic space

We study the horospherical geometry of submanifolds in hyperbolic space. The main result is a formula for the total absolute horospherical curvature of M, which implies, for the horospherical geometry, the analogues of classical inequalities of the Euclidean Geometry. We prove the horospherical Chern-Lashof inequality for surfaces in 3-space and the horospherical Fenchel and Fary-Milnor`s theorems.

GLUON SATURATION AND THE TOTAL PROTON-AIR CROSS SECTION

In this work we propose a simple model for the total proton-air cross section, which is an improvement of the minijet model with the inclusion of a window in the p(T)-spectrum associated to the saturation physics. Our approach introduces a natural cutoff for the perturbative calculations which modifies the energy behavior of this component. The saturated component is calculated with a dipole model. The results are compared with experimental cross sections measured in cosmic ray experiments.

Breakup effects in fusion and total reaction cross sections of weakly bound systems

We use a new technique to investigate the systematic behavior of near barrier complete fusion, total fusion and total reaction cross sections of weakly bound systems. A dimensionless fusion excitation function is used as a benchmark to which renormalized fusion data are compared and dynamic breakup effects can be disentangled from static effects. The same reduction procedure is used to study the effect of the direct reaction mechanisms on the total reaction cross section.

Universal trend for heavy-ion total reaction cross-sections at energies above the Coulomb barrier

Heavy-ion total reaction cross-section measurements for more than 1100 reaction cases covering 61 target nuclei in the range (6)Li-(238)U and 158 projectile nuclei from (2)H to (84)Kr (mostly exotic ones) have been analyzed in a systematic way by using an empirical, three-parameter formula that is applicable to the cases of projectile kinetic energies above the Coulomb barrier. The analysis has shown that the average total nuclear binding energy per nucleon of the interacting nuclei and their radii are the chief quantities that describe the cross-section patterns. A great amount of cross-section data (87%) has been quite satisfactorily reproduced by the proposed formula; therefore, the total reaction cross-section predictions for new, not yet experimentally investigated reaction cases can be obtained within 25% (or much less) uncertainty.