Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital

Background: the incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004.Methods: the incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15 253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related.Results: There were 35 cardiac arrests (22.9 : 10 000) and 15 deaths (9.8 : 10 000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10 000) - four totally (2.62 : 10 000) and three partially related to anesthesia (1.96 : 10 000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%).Conclusions: Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.

Association between Discoid Lupus erythematosus and Cigarette Smoking - A case-control study

Background. Discoid lupus erythernatosus (DLE) is a chronic cutaneous disease affecting photoexposed areas and has also been associated with cigarette smoking. Objective: To evaluate the association between smoking and DLE. Methods: A case-control study was performed involving 57 cases diagnosed with DLE and 215 healthy controls. Results:A higher smoking prevalence was noted in DLE cases (84.2%) than controls (33.5%), and the odds ratio adjusted for gender, age and ultraviolet index in the city of origin was 14.4 (95% confidence interval 6.2-33.8; multiple logistic regression, p < 0.01). The cumulative smoking exposure was not related to premature DLE development. At the beginning of the disease, smokers had more extensive involvement than nonsmokers; compromise of the upper arms was statistically related to smoking. Conclusion: Cigarette smoking was statistically associated with DLE development. Other studies are needed in order to evaluate the effects of smoking cessation on the course of disease. Copyright (c) 2005 S. Karger AG, Basel.

Vocal Polyps: Clinical, Morphological, and Immunohistochemical Aspects

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Geographic analysis on the occurrence of human and canine leptospirosis in the city of Maringá, state of Paraná, Brazil

INTRODUÇÃO: Leptospirose é uma zoonose que tem como hospedeiros primários os animais silvestres, sinantrópicos e domésticos. Os humanos comportam-se como hospedeiros terminais e acidentais. Sua prevalência depende dos animais portadores que disseminam o agente, de sua sobrevivência ambiental e do contato de pessoas susceptíveis. Cada sorovar tem um ou mais hospedeiros com diferentes níveis de adaptação. Os focos de leptospirose devem-se aos animais infectados, doentes e assintomáticos, considerados como fontes de infecção ambiental. O objetivo deste estudo foi determinar áreas de risco da infecção leptospírica em cães errantes e pacientes com diagnóstico de leptospirose nos anos de 2006 a 2008, em Maringá, Estado do Paraná, Brasil. MÉTODOS: Foram estudados 335 cães errantes e 25 pacientes. Os soros, tanto dos animais como dos pacientes, foram examinados pela prova de soroaglutinação microscópica (SAM), para pesquisa de anticorpos antileptospíricos. Para determinar áreas de risco e a distribuição espacial da doença foram elaborados mapas temáticos. RESULTADOS: Foram observados 41(12,2%) cães positivos para um ou mais sorovares de leptospiras, e os mais frequentes foram: Pyrogenes (43,9%), Canícola (21,9%) e Copennhageni (19,5%). Nos humanos, a positividade foi de 2 (8%) para os sorovares, Pyrogenes e Hardjo Prajitno e, Pyrogenes e Cynopteri. CONCLUSÕES: A análise espacial revelou que o risco de cães e humanos, no município de Maringá, se infectar com leptospiras está presente tanto em áreas centrais como periféricas, fato que reforça a relevância deste estudo e de ações contínuas de vigilância epidemiológica e ambiental para o controle da doença tanto nos animais como no homem.

Canine rabies epidemiology in Araçatuba and neighborhood, Northwestern São Paulo State - Brazil

São apresentadas algumas características epidemiológicas da raiva canina na região de Araçatuba, no período de 1993 a 1997. Dentre 1.984 cães submetidos ao diagnóstico de raiva, 351 foram positivos sendo que 89% dos casos (312/351) ocorreram na zona urbana e destes, 85% (266/312) eram de animais com proprietário. As informações sobre sexo estavam presentes em 83% das fichas e destas 61% eram de machos. A média de idade dos cães positivos foi de 34 meses. A agressividade foi um dos sintomas mais comumente observado (77%), seguido por incoordenação motora e/ou paralisia (42%) e 48% dos cães positivos haviam agredido pessoas ou outros animais. Das 182 fichas epidemiológicas que possuíam dados de vacinação, 51% (92/182) dos cães não eram vacinados. Aponta-se como possíveis razões para o aparecimento da epidemia no município de Araçatuba a baixa cobertura vacinal demonstrada pelo índice de cães não vacinados que adquiriram a doença aliado à elevada relação cão/homem (1:3,5) revelada em estudo anterior.

Leaf trait variation on Erythroxylum tortuosum (Erythroxylaceae) and its relationship with oviposition preference and stress by a host-specific leaf miner

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Molecular characterization and phylogenetic analysis of JussuMP-I: A RGD-P-III class hemorrhagic metalloprotease from Bothrops jararacussu snake venom

Snake venom metalloproteases (SVMPs) embody zinc-dependent multidomain enzymes responsible for a relevant pathophysiology in envenomation. including local and systemic hemorrhage. The molecular features responsible for hemorrhagic potency of SVMPs have been associated with their multidomains structures which can target these proteins them to several receptors of different tissues and cellular types. BjussuMP-I. a SVMP isolated from the Bothrops jararacussu venom, has been characterized as a P-III hemorrhagic metalloprotease. The complete cDNA sequence of BjussuMP-I with 1641bp encodes open reading frames of 547 amino acid residues, which conserve the common domains of P-III high molecular weight hemorrhagic metalloproteases: (i) pre-pro-peptide, (ii) metalloprotease, (iii) disintegrin-like and (iv) rich cysteine domain. BjussuMP-I induced lyses in fibrin clots and inhibited collagen- and ADP-induced platelet aggregation. We are reporting, for the first time, the primary structure of an RGD-P-III class snake venom metalloprotease. A phylogenetic analysis of the BjussuMP-1 metalloprotease/catalytic domain was performed to get new insights into the molecular evolution of the metalloproteases. A theoretical molecular model of this domain was built through folding recognition (threading) techniques and refined by molecular dynamics simulation. Then, the final BjussuMP-I catalytic domain model was compared to other SVMPs and Reprolysin family proteins in order to identify eventual structural differences, which could help to understand the biochemical activities of these enzymes. The presence of large hydrophobic areas and some conserved surface charge-positive residues were identified as important features of the SVMPs and other metalloproteases. (C) 2006 Elsevier B.V. All rights reserved.

Spermiogenesis and spermatozoa ultrastructure in five species of the Curimatidae with some considerations on spermatozoal ultrastructure in the Characiformes

A espermiogênese nas espécies Steindachnerina insculpta, Cyphocharax gillii, C. modestus, C. spilotus e Potamorhina altamazonica de Curimatidae é caracterizada pelo desenvolvimento lateral do flagelo, rotação do núcleo, formação excêntrica da fossa nuclear e cromatina compactada em fibras espessas. Estes espermatozóides exibem uma cabeça esférica contendo um núcleo com cromatina altamente condensada em fibras espessas com pequenas áreas eletronlúcidas, e sem acrossoma. A fossa nuclear é do tipo moderado e excêntrico, penetrada pelo complexo centriolar. A peça média é pequena, tem muitas vesículas alongadas e um curto canal citoplasmático. Mitocôndrias podem ser alongadas, ramificadas ou em forma de C, e são separadas do segmento inicial do axonema pelo canal citoplasmático. O flagelo contém a estrutura clássica do axonema (9+2) e tem um compartimento membranoso na região inicial; não possui expansões laterais (fins). Somente pequenas diferenças foram observadas entre as espécies e gêneros analisados de Curimatidae. A espermiogênese e os espermatozóides de Curimatidae têm muitas das características encontradas em quase todas as outras espécies de Characiformes. Por outro lado, a presença de um compartimento membranoso na região inicial do flagelo dos curimatídeos, uma estrutura comum nos espermatozóides de muitos cipriniformes, é desconhecida em outros characiformes. Discute-se sobre a espermiogênese e espermatozóides de Characiformes.

Identification of the shark species Rhizoprionodon lalandii and R-porosus (Elasmobranchii, Carcharhinidae) by multiplex PCR and PCR-RFLP techniques

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Spawning and parental care in Hoplias malabaricus (Teleostei, Characiformes, Erythrinidae) in the Southern Pantanal, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Birds and bats diverge in the qualitative and quantitative components of seed dispersal of a pioneer tree

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Anatomy of smooth muscle cells in nonmalignant and malignant human prostate tissue

Differently graded areas of human prostate adenocarcinoma were examined after Masson's trichrome staining or immunohistochemistry for smooth muscle alpha-actin, type IV collagen and laminin. In addition, the ultrastructure of the prostatic smooth muscle cells (SMC) during glandular proliferation and epithelial invasion in selected tumors was studied. The SMC formed a thick layer below the epithelial structures in unaffected areas and were closely associated with each other in homotypic interactions. As the tumor grade increased, the SMC gradually lost interactions with each other and became atrophic. With the growth of the epithelial compartment, the SMC initially segregated to the tumor periphery and the intercellular spaces increased. In high grade tumors, the epithelial cancer cells invaded the spaces between the SMC. Immunohistochemical analysis of the basal membrane revealed increased disruption of the usually thick basal membrane, which became thinner and faintly stained with each of the antibodies used. We conclude that most SMC become atrophic following epithelial invasion in human tumors and that degradation of the basal membrane is an important factor in this process. At the ultrastructural level, different SMC phenotypes occur in prostatic tissues during epithelial invasion. Interconversion between these phenotypes is suggested and a probable relationship among them is proposed.

Concurrent dengue and malaria in the Amazon region

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microhabitat use by species of the genera Bothrops and Crotalus (Viperidae) in semi-extensive captivity

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Root surface treatment using diode laser in delayed tooth replantation: radiographic and histomorphometric analyses in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)