Obstrução nasolacrimal congênita - Diagnóstico e tratamento

This article assembled the congenital lacrimal obstruction according embryology, clinical presentation, propedeutic exams and other differential anomalies.

Blefarospasmo essencial e espasmo hemifacial: Características dos pacientes, tratamento com toxina botulínica A e revisão da literatura

Purpose: To evaluate the characteristics of the essential blepharospasm and hemifacial spasm patients and the feasible treatment with botulinum toxin. A. Methods: Thirty-four essential blepharospasm or hemifacial spasm patients were evaluated according to gender, ocular complaint, time of disease, treatment outcome and complications. Results: Age median was 63 years and the mean was 61 years, with no difference regarding sex; 66.66% of the patients had hemifacial spasm and 33.33%, essential blepharospasm. Many patients complained of dry eye associated with involuntary spasm. Botulinum toxin A showed a positive outcome in 91.30% of the treated patients and complications observed after treatment were eyelid ptosis (8.33%) and buccal angle deviation (8.33%). Conclusion: Essential blepharospasm and hemifacial spasm occurred in the elderly, of both sexes. Treatment with botulinum toxin A was useful, with very low complication rates.

Inibidores da HIV-integrase: Potencial abordagem farmacológica para tratamento da AIDS

AIDS has the HIV as its etiological agent. Researches has been done to find new pharmacological agents to be used in therapy, because of problems of resistance and side effects. The HIV-integrase inhibitors are some of those new agents that are being studied. This updating focusses on the fundamental information about HIV and HIV-integrase and the main methods being used to develop these new drugs, with examples for each case.

Tratamento de esgoto sanitário utilizando reatores anaeróbios operados em bateladas sequenciais (escala piloto)

The performances of two anaerobic sequencing batch reactors (1.2 m 3) containing biomass immobilized in inert support and as granular sludge in the treatment of domestic sewage from the Campus of São Carlos-University of São Paulo were evaluated. The experimental phase lasted seventy days. During this period, the reactors presented quite similar performances in respect to COD and total suspended solids removal, achieving average efficiencies of approximately 60% and 75%, respectively. The analysis using molecular biology techniques on biomass samples taken at 35 th and 70 th showed differences in the bacterial community in the reactors indicating that the type of biomass immobilization selected the populations differently. A higher similarity was found for the Archaea domain probably because these microorganisms utilize specific substrates formed at the end of the anaerobic process.

Distúrbio de hiperatividade e déficit de atenção na síndrome de apnéia obstrutuiva do sono: Há melhora com tratamento cirúrgico?

Neuropsychological disorders are frequently associated with obstructive ventilatory disorders (OVD). Aim: To analyze the incidence of neuropsychological disorders in Brazilian children with OVD, using a screening questionnaire and to compare the answers given before and after surgery. Patients and Methods: We studied 30 children with clinical diagnosis of OVD. The children were divided into 3 groups: group I, children aged 4 to 7; group II, from 8 to 10; and group III, children over 11. The applied questionnaires were answered by the parents or tutors, and comprised 30 questions, 10 for each disorder: attention deficit, hyperactivity and impulsivity. The children were diagnosed with one of the disorders when presented 3 or more positive answers. The follow up interview occurred 6 months after adenotonsillectomy. Results: There was a predominance of male gender (60.6%) over female gender (39.4%). Group II presented the highest number of significant changes, with reductions raging from 87.5% to 33.3% of patients with attention deficit, 75% to 50% of the hyperactive patients, and 50% to 33% of the impulsive patients. Conclusion: There was neuropsychological improvement after the surgery, which occurred mainly in the children from group II. More interaction among health professionals is necessary when diagnosing and following up similar cases.

Associação do hidróxido de cálcio e metronidazol no tratamento de dentes de cães com lesão periapical crônica

One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. AIM: The purpose of this study was to analyze the response of the periapical tissue of dogs' teeth with chronic periapical lesions to endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings. METHODOLOGY: Forty root canals were submitted to pulpectomy and the root canals were kept exposed to the oral environment for 6 months. Then, they were submitted to biomechanical preparation and divided into 4 study groups with 10 specimens: group I - no root canal dressing; group II - calcium hydroxide; group III - metronidazole; group IV - calcium hydroxide associated to metronidazole. After 15 days, the root canals were filled with Fill Canal sealer. After 90 days, the animals were killed and the especimens processed for histological analysis. RESULTS: Calcium hydroxide dressing provided a significantly better outcome compared to other experimental groups (α = 0.01). Also, the results of the association of metronidazole and calcium hydroxide were similar to those observed for the metronidazole group. The worst results were obtained by the no root canal dressing group. CONCLUSION: The use of metronidazole alone or associated with Calcium hydroxide, did not improve periapical healing when compared to Calcium hydroxide dressing.

Estudo biológico e biométrico dos estádios ninfais de Rhodnius prolixus Stäl, 1859 (Hemiptera, Reduviidae) sob condições laboratoriais

Eggs and nymphs originated from couples of Rhodnius prolixus obtained from nymphs of the 5th instar were used for biological cycle and biometric studies. The following biological cycle parameters were determined under a temperature of 28°C and relative humidity, varying between 52 - 94% : medium period of incubation: 13.01 days; rate of eggs eclosion: 77.6%; medium period of development of the 1st, 2nd, 3rd, 4 th, 5th instar nymphs : 19.33, 19.09, 20.38, 24.37, 38.14 days, respectively; percentual of deaths in the nymph instar: 26.70, 14.00, 18.26, 17.02, 35.47% respectively; percentual of changes per instar nymphs; 73.30, 86.03, 81.73, 82.97, 64.52%, respectively. Biometric measurements performed, showed that in all the instars the abdomen is the largest segment. In the four first instars, the head is larger than the thorax. In the fifth instar, the head and thorax present are about the same size.

Causas de ambliopia e resultados do tratamento

Objective: to evaluate the causes and the results of occlusion amblyopia treatment. Methods: a retrospective study was done including children under 12 years old. Sex, age of starting treatment, etiology, ocular deviation affection, visual acuity and time for the occlusion treatment were evaluated. Results: 158 children had all the requirements to compose the sample. 50.6% were males. 70.2% had esotropia, 13.2% exotropia, 0.7% hypertropia and 4.4% presented horizontal and vertical strabismus. 11.4% had no ocular deviation. 6.6% presented anisometropia, 0.7% congenital cataract and 6.6% other diagnoses. Visual acuity improved in 85.5%, faster in the ortophoric children. The occlusion treatment time was long in all the deviation types. Conclusion: the treatment was beneficial in improving amblyopia in the majority of the children evaluated.

Comportamento contrátil de barreiras selantes de solo estabilizado para base de lagoas de tratamento

Liners were proposed as subsoil contamination protection devices for waste disposal sites. In the rural environment, they can be used to construct pond bottoms for liquid waste treatment, but the construction needs to be quick and cheap. A good technical solution for these situations is the use of local soil compacted with low quantities of cement or lime, obtaining good properties for this purpose. These barriers need special care about their contraction behavior which may compromise its use. This work shows the results of contraction tests in sandy soil specimens and others stabilized with lime and with cement. Soil structure changes during cure time were checked using electronic scan microscopy. Results show maximum soil contraction of 0.648% for specimen with 14 days cure process. After twenty eight days of cure the contraction values were lower than 0.5%, which classifies the material as of low contraction. Electronic scan image shows significant material structure alteration up to seven days cure. Results show that studied mixtures had appropriate contraction behavior for liner usage.

Sertralina no tratamento de pacientes com depressão maior leve e moderada: Estudo multicêntrico brasileiro

Introduction: To evaluate the efficacy, safety, and tolerability of sertraline for the treatment of Brazilian patients with mild to moderate major depression. Patients and methods: Patients were 18 years old or older treated on an out-patient basis. Previous medications were stopped for a 2-week washout period. Afterwards, patients received sertraline, initial dose of 50 mg/day up to the 4 th week. The dose could then be increased up to 200 mg/day according to the efficacy and tolerability. Therapeutic efficacy was evaluated with the Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton scale for depression (HAM-D), and Clinical Global Impression (CGI). Results: 51 patients (42 women) were evaluated regarding efficacy and safety. Treatment with sertraline significantly decreased scores of MADRS, HAM-D e ICGfrom 15.7 ± 6.1; 12.2 ± 3.9 e 3.5 ± 0.6 to 6.2 ± 6.5; 5.4 ± 4.7 e 2.3 ± 1.0 (P < 0.0001), respectively. Sertraline was well tolerated. Gastro-intestinal upset (N=14; 24.6%), headache (N=7; 12.3%), sleep alterations (H-7; 12.3%), dizziness (N-4; 7.0%), and anorexia (N=4; 7.0%) were the most common adverse events. Six patients discontinued the treatment due to adverse events. Conclusion: Sertraline is efficient and presents a favorable safety and tolerability profile for the treatment of Brazilian patients with mild to moderate major depression. © Copyright Moreira Jr. Editora.

Síndrome das pernas inquietas: Diagnóstico e tratamento. Opinião de especialistas Brasileiros

This article contains the conclusions of the November 17-18, 2006 meeting of the Brazilian Study Group of Restless Legs Syndrome (GBE-SPI) about diagnosis and management of restless legs syndrome (RLS). RLS is characterized by abnormal sensations mostly but not exclusively in the legs which worsen in the evening and are improved by motion of the affected body part. Its diagnosis is solely based on clinical findings. Therapeutic agents with efficacy supported by Class I studies are dopamine agonists, levodopa and gabapentine. Class II studies support the use of slow release valproic acid, clonazepan and oxycodone. The GBE-SPI recommendations for management of SPI are sleep hygiene, withdrawal of medications capable of worsening the condition, treatment of comorbidities and pharmacological agents. The first choice agents are dopaminergic drugs, second choice are gabapentine or oxycodone, and the third choice are clonazepan or slow release valproic acid.

Tratamento de efluentes de carcinicultura por macrófitas aquáticas flutuantes

The efficiency of systems composed of two species of floating aquatic macrophyte (Eichhornia crassipes and Pistia stratiotes) to treat effluents from shrimp culture was evaluated in this research. The effluent originated from a pond populated with Macrobrachium amazonicum. Treatment systems consisted of 12 experimental tanks with aquatic macrophyte and three tanks without plants (control). Water samples were collected from the fresh water supply and before and after passing through the treatment systems. There are no differences in the removal of nutrients between the two species. The higher nutrient removal was observed for total phosphorus (41.9% by control; 71.6% by E. crassipes; 69.9 by P. stratiotes; 72.5% by E. crassipes + P. stratiotes and 72.1 by P. stratiotes + E. crassipes) and turbidity (30.6% by control; 80.2% by E. crassipes; 75.2 by P. stratiotes; 79.8% by E. crassipes + P. stratiotes and 81.5 by P. stratiotes + E. crassipes). The systems containing aquatic macrophytes were efficient in nitrogen and phosphorus removal from M. amazonicum culture. © 2008 Sociedade Brasileira de Zootecnia.

Análise de econometria de dois sistemas naturais de tratamento de água residuária na suinocultura

The aim of this work was to develop a detailed econometric analysis to compare a constructed wetland system - combined model, and a waste stabilization pond system - facultative pond, as a function of six different sizes of finishing pig farms and two waste management systems - wet and dry. The constructed wetland system using dried waste management showed the best economic results. This finding is due to the low-cost implementation a year both per animal and per kilogram of meat. This system also required the smallest area for waste treatment. The use of stabilization pond with wet waste management system showed a lower implementation cost a year per animal and per kilogram of meat, but it required large areas. The econometric analysis of both systems of wastewater treatment revealed an economy of scale.

Infliximabe no tratamento inicial da retocolite ulcerativa moderada e grave. Terapia top down: Relato preliminar

The first option for the treatment of UC is both: salicylates or corticoids. Recently, in late November of 2006, the Brazilian Ministry of Health has approved infliximab (Remicade c, Mantecorp, Brazil) to treat ulcerative colitis. We report the use of infliximab as a first option for the treatment of two patients with severe ulcerative colitis. Case report: Patient 1: AZF, 52 years-old, female, was first diagnosed with UC after history and clinical examination; colonoscopy showed pancolitis with positive biopsy (crypt microabscess). Her Mayo score was 10 (range: 0 to 12/asymptomatic to severe colitis). She received intra venous infusion of infliximab at a dose of 5mg/Kg of body weigh at week 0, 2, 6 and 14. Then, patient was given mesalazine 4.5 g/day for maintenance therapy. Clinical response was defined as a decreased from baseline in the total Mayo score of at least 3 points. At present, patient is asymptomatic with Mayo score of 3 one moth after the last dose of infliximab. Patient 2: MLA, 45 years-old, female was first diagnosed with bloody diarrhea; colonoscopy showed left colitis and the biopsy was positive for ulcerative colitis. Her Mayo score was 9. She was offered and accepted the step down treatment. She was given infliximab 5mg/Kg of body weight at week 0, 2, 6 and 14. After initial treatment with infliximab, she received mesalazine 4.2 g/day. At present, she is asymptomatic with Mayo score of 2 eighteen days after the last dose of infliximab. At our knowledge, this is the first Brazilian report of the use of infliximab as fist-line therapy in ulcerative colitis. Few days after the begging of the infusion, an impressive clinical and colonoscopy improvement was seen in these two patients. Recently, it has been reported the use of infliximab as first-line therapy in pediatric Crohn disease. Infliximab could be a good option in cases of moderate and severe UC to avoid the side effects of the use of high doses of corticoids in patients with moderate and severe UC. However, the question if step-down therapy in ulcerative colitis is better then conventional therapy with salicylates and corticoids needs to be answered by randomized trials.