Perfuração espontânea de colédoco em adolescente

Spontaneous perforation of the common bile duct is rare. It happens predominantly in children and it is related to obstructive disease of the biliary tract. We present a case of an 18 year-old male patient, with ulcerative rectocolitis associated with malignant tumor of the head of pancreas. The patient developed an acute abdomen syndrome and laparotomy, a spontaneous perforation of common bile duct was evidenced. The authors make a revision of the clinical aspects of that pathology

Processo de difusão com agregação e reorganização espontânea em uma rede 2D

Difusive processes are extremely common in Nature. Many complex systems, such as microbial colonies, colloidal aggregates, difusion of fluids, and migration of populations, involve a large number of similar units that form fractal structures. A new model of difusive agregation was proposed recently by Filoche and Sapoval [68]. Based on their work, we develop a model called Difusion with Aggregation and Spontaneous Reorganization . This model consists of a set of particles with excluded volume interactions, which perform random walks on a square lattice. Initially, the lattice is occupied with a density p = N/L2 of particles occupying distinct, randomly chosen positions. One of the particles is selected at random as the active particle. This particle executes a random walk until it visits a site occupied by another particle, j. When this happens, the active particle is rejected back to its previous position (neighboring particle j), and a new active particle is selected at random from the set of N particles. Following an initial transient, the system attains a stationary regime. In this work we study the stationary regime, focusing on scaling properties of the particle distribution, as characterized by the pair correlation function ø(r). The latter is calculated by averaging over a long sequence of configurations generated in the stationary regime, using systems of size 50, 75, 100, 150, . . . , 700. The pair correlation function exhibits distinct behaviors in three diferent density ranges, which we term subcritical, critical, and supercritical. We show that in the subcritical regime, the particle distribution is characterized by a fractal dimension. We also analyze the decay of temporal correlations

Perfuração espontânea de colédoco em adolescente

Spontaneous perforation of the common bile duct is rare. It happens predominantly in children and it is related to obstructive disease of the biliary tract. We present a case of an 18 year-old male patient, with ulcerative rectocolitis associated with malignant tumor of the head of pancreas. The patient developed an acute abdomen syndrome and laparotomy, a spontaneous perforation of common bile duct was evidenced. The authors make a revision of the clinical aspects of that pathology

Percepção Ambiental em Museus Paisagens de Arte Contemporânea: a legibilidade dos museus Inhotim/Brasil e em Serralves/Portugal avaliada pelo público/visitante

This thesis nalyzes the wayfinding in Landscape Museum of Contemporary Art (MPAC), based on the Institute of Contemporary Art CACI, Minas Gerais, Brazil and the Museum of Contemporary Art of the Serralves Foundation, Porto, Portugal. The study focuses on the interrelationship of the public/visitors with the landscape, architecture and contemporary art museums in these, in order to understand visual perception and apprehension of such an environment for their users. For both were confronted documentation (visual and written) and people talk. The main hypothesis put forward is that the audience/visitor MPAC appreciates the interrelationship between the natural environment (park/garden) and built environment (the works of contemporary art and the galleries), giving equal value to both. To complement this, a second hypothesis is that during the visit to MPACS, visitors define their paths spontaneously, but strongly influenced by existing visual indicators (maps, signage and striking landscape elements), which facilitate the readability of space, which also contribute to the offered services and the experiences of similar institutions. The analytical basis of the research used the concepts of legibility (LYNCH, 2009), wayfinding (GIBSON, 2009; ARTHUR, PASSINI, 2002; WEISMAN, 1982), Experiential Cotinnum (TUAN, 1985), Space Bound (CRUZ PINTO, 2007) and habitus (BOURDIEU, 1992). Methodologically was used qualitative research (DEMO 2000) by means of a case study (YIN, 2005; STAKE, 1999) and participant observation (WHYTE, 2005). In the two institutions interviews with researchers and curators, behavior observation and questionnaires from employees, trainees, monitors and the public/visitor of the two museums were performed. Although partially referende the initial hypothesis, the research showed that the public/visitor value appears more natural environments, they experience a greater intensity and in addition to the factors listed in the second case, your perception and definition of paths suffer significant influence of emotional relations established with space. Generally the audience/visitor adapts easily to different demands of contemporary art exhibition in the two museums and the built environment (park/garden and museum) interferes with your reading path during the visit, perceived by the public/visitor condition as a factor that favors the enjoyment of works on different mounts (wayfinding), though often become a factor that hinders the legibility of the building and its built environment

Influência do vírus da hepatite G (GBV-C) na resposta imune frente à infecção por Leishmania chagasi

GB virus type C (GBV-C) appears to promote a Th1 response and is associated with prolonged survival in HIV-infected people. L. chagasi causes a spectrum of illness that varies from severe visceral leishmaniasis, a disease that in the majority of cases is fatal if not treated, to self resolution of infection and development of positive DTH response that is protective against symptomatic disease. To determine if GBV-C viremia might influence the outcome of Leishmania infection, we characterized GBV-C status in a cohort of subjects residing in a L. chagasi endemic area in Brazil. GBV-C viremia was more prevalent in blood donors from urban than in periurban regions of Natal, Brazil (16% and 7.5% respectively). Evidence of prior GBV-C (anti-E2 antibodies) was detected in 24% and 12%of these groups respectively. Anti-E2 increased with age (p= 0.0121). No difference in GBV-C viremia was found in the DTH+ and VL groups (p= 0.269); however, subjects with visceral leishmaniasis were more likely to have anti-E2 than DTH+ subjects (p=0.0012), and DTH induration was smaller in subjects with E2 antibodies (4.5 mm) compared those without (7.12 mm) (p= 0.002). Furthermore, the size of the Leishmania DTH response was greater in GBV-C viremica subjects (6.8 mm) compared to non-viremic subjects (3.3 mm; p= 0.0054). There findings suggest that GBV-C virus may promote a type 1 immune response that could influence the outcome of Leishmania infection

Avaliação do efeito do composto tipo heparina isolado do caranguejo Chaceon fenneri na hemostasia e na morte celular

Heparin is a pharmaceutical animal widely used in medicine due to its potent anticoagulant effect. Furthermore, it has the ability to inhibit the proliferation, invasion and adhesion of cancer cells to vascular endothelium. However, its clinical applicability can be compromised by side effects such as bleeding. Thus, the search for natural compounds with low bleeding risk and possible therapeutic applicability has been targeted by several research groups. From this perspective, this study aims to evaluate the hemorrhagic and anticoagulant activities and citotoxic effect for different tumor cell lines (HeLa, B16-F10, HepG2, HS-5,) and fibroblast cells (3T3) of the Heparin-like from the crab Chaceon fenneri (HEP-like). The HEP-like was purified after proteolysis, ion-exchange chromatography, fractionation with acetone and characterized by electrophoresis (agarose gel) and enzymatic degradation. Hep-like showed eletroforetic behavior similar to mammalian heparin, and high trisulfated /Nacetylated disaccharides ratio. In addition, HEP-like presented low in vitro anticoagulant activity using aPTT and a minor hemorrhagic effect when compared to mammalian heparin. Furthermore, the HEP-like showed significant cytotoxic effect (p<0.001) on HeLa, HepG2 and B16-F10 tumor cells with IC50 values of 1000 ug/mL, after incubation for 72 hours. To assess the influence of heparin-like on the cell cycle in HeLa cells, analysis was performed by flow cytometry. The results of this analysis showed that HEP-like influence on the cell cycle increasing S phase and decreasing phase G2. Thus, these properties of HEP-like make these compounds potential therapeutic agents

Efeito anti-inflamatório do heparinóide isolado do camarão Litopenaeus vannamei sobre a peritonite aguda

In recent years the heparin has been the subject of several studies that aim to expand its use as a therapeutic agent, due to its ability to modulate the activity of various proteins that play important roles in the regulation of pathophysiological processes. In several experiments and preclinical trials, heparin has demonstrated an anti-inflammatory role. However, its clinical use is limited, due to its strong anticoagulant activity and hemorrhagic complications. For this reason, considerable efforts have been employed in discovery of heparin analogous (heparinoid) with reduced side effects, that retain the anti-inflammatory properties of heparin. In this context, a heparinoid obtained from the head of Litopenaeus vannamei shrimp, which presents a structural similarity to heparin, showed, in previous studies, anti-inflammatory activity in a model of acute peritonitis with reduced anticoagulant effect in vitro and low hemorrhagic activity. Thus, the present work had as objective to evaluate the effect the heparinoid of the cephalothorax of gray shrimp on the acute inflammatory response in different times (3 or 6 hours after the induction of inflammatory stimulus), using the model of acute peritonitis induced in mice. It was also analyzed the HL effect over the activity of elastase, an enzyme involved in leukocyte recruitment. Furthermore to check if the different doses of heparin and heparinoid change the hemostatic balance in vivo, was assessed the effect of these compounds on the plasma clotting time in animals submitted to inflammation. The results show that in 3 hours, all doses of heparinoid were able to prevent efficiently in the acute inflammatory process without any anticoagulant effects, unlike the extrapolation dose of heparin, which has induced a large hemorrhage due its high anticoagulant activity. However, 6 hours after induction of inflammation, only the dosages of 0.1 and 1.0 μg/Kg of heparin and 1.0 μg/Kg of heparinoid kept anti-migratory effect, without changing of the hemostatic balance. These results indicate that the anti-migratory effect of theses compounds depends on the dosage and time of inflammatory stimulus. The HL and heparin were also able to inhibit the activity of the enzyme elastase. The discovery of this bioactive compound in the cephalothorax of shrimps can arouse great interest in biotechnology, since this compound could be useful as a structural model interesting for the development of new therapeutic agents for peritonitis

Avaliação da suplementação com vitamina E, na forma natural ou sintética, em mulheres no pós-parto imediato e sua concentração no colostro

The Vitamin E consists of eight chemically homologous forms, designated alpha, beta, gamma and delta tocopherols and tocotrienols. Biologically, the alpha-tocopherol (α-TOH) is the most important. Commercially, are found two types of α-TOH a natural (RRR-alpha-tocopherol) and another synthetic (all-rac-alpha-tocopherol). Both forms are absorbed in the intestine, the liver is a preference in favor of forms 2R, due to transfer protein α-TOH. It has higher affinity to these stereoisomers. Newborns are considered high risk for vitamin E deficiency, mainly premature, these have breast milk as a food source for maintenance of serum α-TOH. Clinical signs such as thrombocytosis, hemolytic anemia, retrolental fibroplasia, intraventricular hemorrhage, bronchopulmonary dysplasia and spinocerebellar degeneration can be found in case of a low intake of α-TOH. Thus, maternal supplementation on postpartum with α-TOH can be an efficient way to increase levels of vitamin E in breast milk and thus the consequently increase the supply of micronutrient for the newborn. However, most studies with vitamin E supplementation have been conducted in animals and little is known about the effect of maternal supplementation in humans, as well as on its efficiency to increase levels of α-TOH in human milk, depending on the shape natural or synthetic. The study included 109 women, divided into three groups: control without supplementation (GC) (n=36), supplemented with natural capsule (GNAT) (n=40) and the synthetic capsule (GSINT) (n=33). Blood samples were collected for determination of maternal nutritional status, and colostrums at initial contact and after 24 hours post-supplementation. Analyses were performed by High Performance Liquid Chromatography. Values of α-TOH in serum below 499.6mg/dL were considered deficient. We used the Kruskal-Wallis test and Tukey test to confirm the increase of alpha-tocopherol in milk and efficiency of administered capsules. Daily consumption of α-TOH was based on daily intake of 500 mL of colostrum by the newborn and compared with the nutritional requirement for children from 0 to 6 months of age, 4 mg / day. The mothers had mean concentration of serum α-TOH in 1016 ± 52, 1236 ± 51 and 1083 ± 61 mg / dL, in CG, GNAT and GSINT respectively. There were no women with deficiiency. The GC did not change the concentrations of α-TOH in colostrum. While women supplemented with natural and synthetic forms increased concentrations of α-TOH colostrum in 57.6% and 39%, respectively. By comparing supplemented groups, it was observed a significant difference (p=0.04), the natural capsule more efficient than the synthetic, approximately 49.6%. Individually, 21.1% of the women provided below 4mg/day of α-TOH, after supplementation for this index declined4.1%. Thus, maternal supplementation postpartum raised the levels of alpha-tocopherol in colostrum, and increased efficiency was observed with the natural form

Síntese e caracterização de óxidos de cério e cobalto obtidos por gel-combustão e Pechini aplicados às reações de oxidação de n-hexano

Oxide type spinel AB2O4 presents structure adjusted for application in the automobile industry. The spinel of cobalt has many practical applications had its excellent physical and chemical properties such as catalyst in hydrocarbon oxidation reaction. The CeO2 has been used in many of these processes because it assigns to a material with excellent thermal resistance and mechanics, high capacity of oxygen stockage (OSC) among others properties. This work deals with the synthesis, characterization and catalytic application of spinel of cobalt and CeO2 with fluorita structure, obtained for method of Pechini and method of Gel-Combustion. The process of Pechini, the puff was obtained at 300 ºC for 2 h in air. In the process of Gel-Combustion the approximately at 350 ºC material was prepared and burnt for Pyrolysis, both had been calcined at 500 ºC, 700 ºC, 900 ºC and 1050 ºC for 2 h in air. The materials of the calcinations had been characterized by TG/DTA, electronic microscopy of sweepings (MEV), spectroscopy of absorption in the infra-red ray (FTIR) and diffraction of X-rays (DRX). The obtained material reaches the phase oxide at 450 oC for Pechini method and 500 °C for combustion method. The samples were submitted catalytic reaction of n-hexane on superficies of materials. The reactor function in molar ration of 0, 85 mol.h-1.g-1 and temperature of system was 450 °C. The sample obtained for Pechini and support in alumine of superficial area of 178,63 m2.g-1 calcined at 700 ºC, give results of catalytic conversions of 39 % and the sample obtained for method of gel-combustion and support in alumina of 150 mesh calcined at 500 ºC result 13 % of conversion. Both method were selective specie C1

Agregação familiar e resultados maternos e perinatais da pré-eclâmpsia severa em população do Rio Grande do Norte

To determine whether there is familiar aggregation of severe preeclampsia in a Brazilian population from Rio Grande do Norte and to characterize the maternal and perinatal outcomes in the studied population. Methods: A case control study was performed with 412 participants who were admitted at Maternidade Escola Januário Cicco (MEJC) for medical care. Of these, 264 subjects presented normal blood pressure and 148 were cases. Cases were composed of eclampsia (n=47), HELLP Syndrome (n=85) and Eclampsia associated with HELLP syndrome (n=16). The diagnosis of these illness were based on the citeria developed by National High Blood Pressure Education Program Working (2000). An interview was performed with each subject and questions related to personal and familiar history of hypertension, preeclampsia, HELLP syndrome and eclampsia. Statistical analysis was performed and comparison of median and mean between cases and controls were performed, with the level of significance of 5%. The Odds-Ratio was determined to estimate the risk of preeclampsia within the families. Results: There were no difference in the demographic data between cases and controls. Previous history of chronic hypertension and preeclampsia was more frequent in the case group. Headaches were more frequent in eclampsia and epigastric pain in the HELLP syndrome cases. Bleeding and oliguria were more frequently found in the eclampsia associated with HELLP syndrome cases. Acute Renal insufficiency was a common complication in the case group, but these cases did not evolve to chronic renal insufficiency. The maternal mortality was 0.4% and the perinatal mortality was high, 223 per 1,000 live births. The 111 risk of a woman to develop preeclampsia whose mother has hypertension or had preeclampsia was respectively 2.5 and 3.5. This risk was increased 5 times, when a sibling has hypertension and 6 times when both sibling and mother had previous history of preeclampsia. Conclusions: This study confirms that there is familiar aggregation of preeclampsia in this Brazilian population. The potential for cardiovascular complications due to development of chronic hypertension indicates the need of closely follow up of women who develop preeclampsia

Fatores litogênicos em pacientes com litíase urinária de Fortaleza, Ceará

Lithiasis is considered a public health issue due to its high prevalence and rates of recurrence. Objective: To identify risk factors for lithiasis in kidney stone patients from Fortaleza, Brazil. In the first stage of the study, the medical records of 197 patients with urinary lithiasis covering the period 1996 2006 were analyzed with regard to clinical and metabolic data. In the second stage, 340 kidney stones were submitted to morphological examination under 10x magnification. According to the external morphology and the cut surface, the stones were classified as pure or mixed, and major and minor components were identified. In addition, the stone fragments of 25 patients treated with lithotripsy were submitted to morphological analysis. In the third stage, a subsample of 50 stones was used in a double-blind comparison of morphological and chemical findings. Results were expressed as concordant, partly concordant (discordant for minor components) or discordant (discordant for major components). The average age of first symptoms was 35.8±13.3 years, with no significant difference between the genders. The male/female ratio was 1:1.7. Recurrence was reported in 53.3% of cases. The main metabolic changes observed were hypernatriuria (80.7%), hypercalciuria (48.7%), low urine volume (43.7%), hyperoxaluria (30.5%) and hyperuricosuria (17.3%). Pure stones represented 34.7% of the total sample of 340 stones. The most common route of elimination was spontaneous for pure stones (49.1%) and surgical for mixed stones (50.5%). Pure stones consisted most frequently of calcium oxalate (OxCa) (59.3%) and uric acid (UA) (23.7%), the former prevalent in women, the latter prevalent in men. The most frequently observed component in mixed stones was OxCa (67.1%), followed by carbapatite (11.2%) and struvite (7.9%). The main components were OxCa and UA for men, and carbapatite and struvite for women. Nearly half (48%) the 25 analyzed fragments were pure, consisting of calcium oxalate dihydrate (COD) (56%), calcium oxalate monohydrate (COM) (48%), phosphate (32%) and UA (20%). Four patients (16%) had infectious stones. In the chemical analysis of the subsample of 50 stones, the most 64 frequently observed major components were calcium (70%), oxalate (66%), ammonium (56%), urate (28%) and carbonate (24%). In the morphological analysis, the main components were calcium and magnesium phosphate (32%), COM (24%), UA (20%), COD (18%) and cystine (6%). Morphological and chemical findings were totally concordant for 38% of the stones, partly concordant in 52% and discordant in 10%. Conclusion: The risk factors for lithiasis in kidney stone patients from Fortaleza (Brazil) were hyperoxaluria, hypercalciuria with or without hypernatriuria, hyperuricosuria and low urine volume

Avaliação do potencial de mutagenicidade e toxidade da lectina hipoglicemiante de folha de Bauhinia monandra (pata-de-vaca)

Medicinal plants have been used since antiquity to treat various human diseases. The leaves of Bauhinia monandra are widely used in Brazil as herbal remedies in the treatment of Diabetes Mellitus. From the leaves of B. monandra was purified a galactose-specific lectin, called BmoLL, which also showed a significant hypoglycemic capacity. Following the proposed rules by decree No 116 of 1996/08/08 of the Ministry of Health of Brazil, the study aimed to evaluate the potential for toxicity and mutagenicity of BmoLL from the use of tests with Escherichia coli strain CC104 (Forward mutagenesis assay) with Salmonella typhimurium strain TA (Kado test), with plasmid pBCKS (Break occurrences in plasmid DNA) and enzyme exonuclease III (Search of abasic sites). The results demonstrated that the lectin was unable to increase the frequency of reverse mutation of strains of S. typhimurium, with and without metabolic activity. However, a significant decrease in the frequency of spontaneous mutation was observed in strains of E. coli, especially in poor repair (CC104mutMmutY), indicating an antioxidant potential of the lectin. BmoLL is unable to generate genotoxic and cytotoxic damage, based on the concentrations and the tests performed

Determinação dos fatores neuroepidemiológicos das crises convulsivas em recém nascidos internados em unidades de terapia intensiva

O objetivo do nosso projeto foi determinar as características dos recém nascidos com crises convulsivas internados em unidades de terapia intensiva. Foi realizada uma pesquisa multicêntrica, observacional, prospectiva, cuja população alvo foi os recém nascidos com crises convulsivas internados em unidades de terapia intensiva, envolvendo equipe multidisciplinar constituída por neurologista infantil, neonatologistas, intensivistas pediátricos, enfermeiros, técnicos de enfermagem e fisioterapêutas. As crises foram definidas pelo critério clínico, com classificação de Volpe. Variáveis relacionadas à gestação, ao parto, características dos recém nascidos, aspectos das crises convulsivas e mortalidade foram analisadas. Estatística: descritiva (freqüências, medidas de tendência central e dispersão) e análise (teste de probabilidade, teste de risco e de acurácia). Comparamos as crises clínicas entre os recém nascidos de termo e pretermo e observamos diferenças com significância estatística na idade de início das crises, mais tardia nos prematuros, na etiologia predominante: hemorragia peri-intraventricular no prematuro e encefalopatia hipóxico-isquêmica no termo e tipo clínico de crise, clônica no pretermo e sutil no termo. Os testes de acurácia utilizados para determinar se o tipo clínico de crise convulsiva é predictor da etiologia da mesma não revelaram resultados positivos. Quanto às características associadas à mortalidade de prematuros com crise convulsiva, observamos associação entre ventilação mecânica e pneumonia com a mortalidade. Existem diferenças clínicas quando comparamos os recém nascidos pretermo e de termo com crises convulsivas, confirmando dados da literatura

Prática do enfermeiro do Programa Saúde da Família PSF na promoção da saúde do adolescente

Attention to the health of adolescents, based on paradigm flexneriano, needs to be overcome. Since the International Conference of Ottawa (1986), the literature is developing a discussion of the promotion of health, based on the paradigm of social production in health, suggests a design to overcome the health care traditional practices. Program Health of the Family PSF has this purpose to transmute the model of existing assistance, where the nurse is an essential element to the work done in the program. Around this context, it is our purpose to analyze the practice of nurse of the PSF for the promotion of health of adolescents, produced by a search of descriptive quantitative approach with the inclusion of qualitative data. Interviews were conducted with 9 nurses 3 units of health of the family USF, Mossoró-RN and applied questionnaires with 74 teenagers aged between 15 and 19 years old, with some nearby public schools where USF operate these nurses. The quantitative descriptions were transformed on tables, pictures and graphics using the program Excel (Microsoft) and the qualitative were worked through the technique of analyzing the content of Bardin (2004). The review was realized using the reference to promote health brought by the study. The results show that the most common problems that happen with teenagers are the drugs (33,8%), pregnancy (27,0%) and political problems-socio-economic-cultural issues (24,3%). Adolescents are spontaneous demand and rarely seek the USF. The actions presented by the nurses as, lectures and groups, are nothing comparing to the macro-problems presented by adolescents, and verticalized irregular. The nurses know the promotion of health generally, not explaining how operate it from its daily practice. Concluded that the practice of nurse of the PSF has not yet reach the promotion of health of the adolescent, being necessary to scheduling modules on the subject to continuous training of teams, professionals from USF, as well as teachers and other staff of schools, giving space to the participation of academic. The discussions should be socialized with the community to discuss possibilities of confrontation of the problems, which also require socio-structural changes. This research can contribute as work-diagnosis, which experienced the reality of care in nursing PSF to a specific group

Análise antropotecnológica do desenvolvimento de novos produtos na produção artesanal : caso das rendeiras de bilro da Vila de Ponta Negra em Natal, RN

Brazilian craft production plays an important role in the generation of employment and income for many families in every state across Brazil. In Natal, Rio Grande do Norte, Brazil, among many types found, identifies itself with the production of bobbin-lace, still practiced in Ponta Negra Village for ancient craftswomens of city that try to preserve the art and tradition of bobbin-lace. This work presents the results of an analysis conducted based in concepts of anthropotechnology, on the effects of a design workshop held with bobbin-lace craftswomen in the village of Ponta Negra in July of 2006. The workshop was intended to propose a new concept of products and a new alternative for production in the activity of the craftswomen, on the premise that the laces could be used as a detail inserted into other industrial products such as shirts, bags, towels, etc. Evaluations after the workshop showed that none of the artisans continued to work, indicating that actions focused solely on products did not generate representative results in the production of bobbin-lace. Evaluations also indicated that knowledge about the artisan's personal and professional characteristics, organization, pace, workload, and cultural and historical issues that permeate the activity are essential to the success of technology transfer, particularly when the transfer affects the craft production as it relates to the inseparable aspects of the craftswomen's work and lifestyle