Benign focal seizures of adolescence and neuropsychological findings in patients from community

RATIONALE: Benign focal seizures of adolescence (BFSA) described by Loiseau et al in 1972, is considered a rare entity, but maybe underdiagnosed. Although mild neuropsychological deficits have been reported in patients with benign epilepsies of childhood, these evaluations have not so far been described in BFSA. The aim of this study is to evaluate neuropsychological functions in BFSA with new onset seizures (<12 months). METHODS: Eight patients with BFSA (according to Loiseau et al, 1972, focal or secondarily tonic clonic generalized seizures between the ages of 10-18 yrs., normal neurologic examination, normal EEG or with mild focal abnormalities) initiated in the last 12 months were studied between July 2008 to May 2009. They were referred from the Pediatric Emergency Section of the Hospital Universitário of the University of Sao Paulo, a secondary care regionalized facility located in a district of middle-low income in Sao Paulo city, Brazil. The study was approved by the Ethics Committee of the Institution. All patients performed neurological, EEG, brain CT and neuropsychological evaluation which consisted of Raven's Special Progressive Matrices - General and Special Scale (according to different ages), Wechsler Children Intelligence Scale-WISC III with ACID Profile, Trail Making Test A/B, Stroop Test, Bender Visuo-Motor Test, Rey Complex Figure, Rey Auditory Verbal Learning Test-RAVLT, Boston Naming Test, Fluency Verbal for phonological and also conceptual patterns - FAS/Animals and Hooper Visual Organization Test. For academic achievement, we used a Brazilian test for named "Teste do Desempenho Escolar", which evaluates abilities to read, write and calculate according to school grade. RESULTS: There were 2 boys and 6 girls, with ages ranging from 10 yrs. 9 m to 14 yrs. 3 m. Most (7/8) of the patients presented one to two seizures and only three of them received antiepileptic drugs (AEDs). Six had mild EEG focal abnormalities and all had normal brain CT. All were literate, attended regular public schools and scored in a median range for IQ, and seven showed discrete higher scores for the verbal subtests. There were low scores for attention in different modalities in six patients, mainly in alternated attention as well as inhibitory subtests (Stroop test and Trail Making Test part B). Four of the latter cases who showed impairment both in alternated and inhibitory attention were not taking AEDs. Visual memory was impaired in five patients (Rey Complex Figure). Executive functions analysis showed deficits in working memory in five, mostly observed in Digits Indirect Order and Arithmetic tests (WISC III). Reading and writing skills were below the expected average for school grade in six patients according to the achievement scholar performance test utilized. One patient of this series who had the best scores in all tests was taking phenobarbital. CONCLUSIONS: Neuropsychological imbalance between normal IQ and mild dysfunctions such as in attention domain and in some executive abilities like working memory and planning, as well as difficulties in visual memory and in reading and writing, were described in this group of patients with BFSA from community. This may reflect mild higher level neurological dysfunctions in adolescence idiopathic focal seizures probably caused by an underlying dysmaturative epileptogenic process. Although academic problems often have multiple causes, a specific educational approach may be necessary in these adolescents, in order to improve their scholastic achievements, helping in this way, to decrease the stigma associated to epileptic seizures in the community.

Uso da manta térmica na prevenção da hipotermia intraoperatória

OBJETIVO: A hipotermia é prejudicial no período perioperatório. Não há consenso sobre o melhor método de aquecimento ativo e nem sobre o melhor período para fazê-lo. Este estudo teve como objetivo primário verificar a eficácia de diferentes períodos de utilização da manta térmica à temperatura de 38°C, como método de prevenção da hipotermia intraoperatória. Como objetivo secundário avaliou-se os efeitos adversos do uso da manta térmica na temperatura de 38°C. MÉTODOS: Foram comparados quatro grupos de 15 pacientes submetidos a operações ortopédicas. No grupo controle (Gcont) os pacientes não utilizaram manta térmica, nos grupos pré (Gpré), intra (Gintra) e total (Gtotal), os pacientes utilizaram manta térmica a 38ºC, respectivamente, durante 30 minutos antes da indução anestésica, após a indução anestésica até 120 minutos e antes e após a indução. Foram avaliados: temperatura central (timpânica), periférica (pele), da sala cirúrgica, variação das condições hemodinâmicas e efeitos adversos do aquecimento. RESULTADOS: O Gtotal foi o único grupo que não teve variação significativa da temperatura central. A temperatura central dos pacientes do grupo Gtotal foi significativamente maior (p <0,05) do que a dos outros grupos aos 60 e 120 min após a indução. Os pacientes dos grupos Gcont, Gpré e Gintra apresentaram hipotermia aos 60 min. CONCLUSÃO: O uso da manta térmica com fluxo de ar aquecido foi eficaz como método de prevenção da hipotermia intraoperatória quando foi empregada desde 30 min antes da indução anestésica até 120 min após o início da anestesia. Nas condições do estudo não ocorreram eventos adversos.

Diferenciação dos feixes vasculares e dos elementos traqueais no rizoma de algumas Cyperaceae

Foram analisados os rizomas de Bulbostylis paradoxa Ness, Cyperus giganteus Vahl, C. odoratus L., Fuirena umbellata Rottb. e Hypolytrum schraderianum Ness. O corpo primário é resultante da atividade dos meristemas apicais e do meristema de espessamento primário (MEP). Também ocorre crescimento em espessura, que é decorrente da atividade do meristema de espessamento secundário (MES). O procâmbio e o MEP originam feixes colaterais em H. schraderianum e feixes anfivasais nas demais espécies. Entretanto, todos os feixes que têm protofloema e protoxilema são de origem procambial. O MES produz floema e xilema constituindo um tecido vascular único. Elementos de vaso foram encontrados na maioria dos caules em estrutura primária e secundária, com exceção de H. schraderianum que, na estrutura secundária, contém apenas traqueídes, informação que respalda a ocorrência de crescimento secundário nas Cyperaceae. Os elementos de vaso apresentam grande variação morfológica; em estrutura primária, geralmente são mais alongados, com apêndices. Os elementos de vaso do crescimento secundário são relativamente mais curtos, apresentam apêndices e ramificações.

Primary and secondary thickening in the stem of Cordyline fruticosa (Agavaceae)

The growth in thickness of monocotyledon stems can be either primary, or primary and secondary. Most of the authors consider this thickening as a result of the PTM (Primary Thickening Meristem) and the STM (Secondary Thickening Meristem) activity. There are differences in the interpretation of which meristem would be responsible for primary thickening. In Cordyline fruticosa the procambium forms two types of vascular bundles: collateral leaf traces (with proto and metaxylem and proto and metaphloem), and concentric cauline bundles (with metaxylem and metaphloem). The procambium also forms the pericycle, the outermost layer of the vascular cylinder consisting of smaller and less intensely colored cells that are divided irregularly to form new vascular bundles. The pericycle continues the procambial activity, but only produces concentric cauline bundles. It was possible to conclude that the pericycle is responsible for the primary thickening of this species. Further away from the apex, the pericyclic cells undergo periclinal divisions and produce a meristematic layer: the secondary thickening meristem. The analysis of serial sections shows that the pericycle and STM are continuous in this species, and it is clear that the STM originates in the pericycle.The endodermis is acknowledged only as the innermost layer of the cortex.

Morphoanatomy of the stem in Cyperaceae

Cyperaceae are usually perennial, with underground stems mainly rhizomatous, however, other stem types may also occur, such as corms and tubers. The underground stems of five Cyperaceae species were examined. Cyperus rotundus and Fuirena umbellata have plagiotropic rhizomes, while C. esculentus, C. odoratus, Hypolytrum schraderianum and Bulbostylis paradoxa have orthotropic rhizomes. Corms occur in C. rotundus and C. esculentus, and stolons in C. esculentus. The primary body originates from the activity of the apical meristem and later, from the primary thickening meristem (PTM). Secondary growth results from secondary thickening meristem (STM) activity, and occurs in rhizomes of H. schraderianum, B. paradoxa, C. odotarus and F. umbellata. The procambium and the PTM give rise to collateral bundles in H. schraderianum, and amphivasal bundles in the remaining species. The STM gives rise to the vascular system with the associated phloem and xylem. According to our results, the concept of stem type in Cyperaceae depends on external morphology, function, life phase, activity of the thickening meristems and the relative amount of parenchyma.

Diversidade de abelhas (Hymenoptera, Apidae) ao longo de um gradiente latitudinal na Mata Atlântica

A Mata Atlântica é um dos ambientes mais ricos e ameaçados do mundo, o que deveria ter estimulado em muito o estudo e a conservação do Bioma, mas a fauna de Hymenoptera permanece ainda relativamente pouco conhecida. Em especial, a fauna de abelhas da floresta ombrófila densa é pouco estudada em comparação à fauna das áreas abertas brasileiras. O projeto temático "Biodiversidade de Hymenoptera e Isoptera: riqueza e diversidade ao longo de um gradiente latitudinal na Mata Atlântica - a floresta úmida do leste do Brasil", integrante do Programa Biota-Fapesp, foi idealizado com o objetivo de catalogar térmitas, formigas e famílias selecionadas de vespas ao longo da Mata Atlântica, disponibilizando dados que permitam melhor embasar a conservação deste bioma. O protocolo de amostragem aplicada para a coleta de himenópteros (excluindo as formigas) empregou armadilhas Malaise, pratos-armadilha de cor amarela e esforço similar na varredura de vegetação ao longo de 17 localidades selecionadas, representando um gradiente de quase 20° de latitude na Mata Atlântica, dos Estados da Paraíba até Santa Catarina. Este protocolo foi definido para otimizar a coleta de vespas, sendo as abelhas um produto secundário da amostragem (levantamentos de abelhas em geral utilizam captura em flores ao longo das estações do ano). No entanto, devido à escala regional do projeto e ao grande esforço de amostragem, uma expressiva quantidade de abelhas foi coletada durante o projeto, incluindo novos registros de abelhas para a Mata Atlântica. Foi amostrado um total de 797 espécimes distribuídos em 105 espécies de abelhas; o grupo de abelhas mais rico e abundante foi Meliponina. Uma análise de correspondência "destendenciada" ('detrended correspondence analysis') aplicada à uma matriz de presença ou ausência de Meliponina revela a relativamente fraca influência do gradiente latitudinal na composição das assembléias de abelhas de Mata Atlântica. Uma listagem das espécies amostradas por localidade, com suas freqüências relativas, é apresentada e discutida.

Hydrodynamics and suspended sediment transport in the Camboriú estuary - Brazil: pre jetty conditions

Estuarine hydrodynamics is a key factor in the definition of the filtering capacity of an estuary and results from the interaction of the processes that control the inlet morphodynamics and those that are acting in the mixing of the water in the estuary. The hydrodynamics and suspended sediment transport in the Camboriú estuary were assessed by two field campaigns conducted in 1998 that covered both neap and spring tide conditions. The period measured represents the estuarine hydrodynamics and sediment transport prior to the construction of the jetty in 2003 and provides important background information for the Camboriú estuary. Each field campaign covered two complete tidal cycles with hourly measurements of currents, salinity, suspended sediment concentration and water level. Results show that the Camboriú estuary is partially mixed with the vertical structure varying as a function of the tidal range and tidal phase. The dynamic estuarine structure can be balanced between the stabilizing effects generated by the vertical density gradient, which produces buoyancy and stratification flows, and the turbulent effects generated by the vertical velocity gradient that generates vertical mixing. The main sediment source for the water column are the bottom sediments, periodically resuspended by the tidal currents. The advective salt and suspended sediment transport was different between neap and spring tides, being more complex at spring tide. The river discharge term was important under both tidal conditions. The tidal correlation term was also important, being dominant in the suspended sediment transport during the spring tide. The gravitational circulation and Stokes drift played a secondary role in the estuarine transport processes.