Uso de dexmedetomidina em anestesiologia

JUSTIFICATIVA E OBJETIVOS: A dexmedetomidina é um novo agonista alfa2-adrenérgico que apresenta relação de seletividade entre os receptores alfa2:alfa1 de 1600:1, com importante ação sedativa e analgésica, bom controle hemodinâmico frente ao estresse e que pode produzir, por si só, anestesia. Este agente tem sido empregado para promover analgesia e sedação no período pós-operatório e nas unidades de tratamento intensivo. Devido à suas propriedades, recentemente, a dexmedetomidina passou a ser utilizada também na sala de operações, como fármaco coadjuvante em anestesia. Assim, este artigo faz uma revisão da literatura com relação ao uso da dexmedetomidina na prática anestésica. CONTEÚDO: São apresentados os principais trabalhos com o emprego da dexmedetomidina em Anestesiologia, seja como medicação pré-anestésica, ou durante o ato anestésico-cirúrgico. O mecanismo de ação dos fármacos alfa2-agonistas e as propriedades farmacocinéticas e farmacodinâmicas da dexmedetomidina também são revistos neste artigo. CONCLUSÕES: O uso da dexmedetomidina como medicação pré-anestésica, durante anestesia, ou no período pós-operatório, promove boa estabilidade hemodinâmica. Há redução do consumo de anestésicos durante a anestesia. Os pacientes sedados com a dexmedetomidina podem ser despertados, quando solicitados, e tornarem-se cooperativos. Mesmo doses elevadas do fármaco não provocam depressão respiratória. Bradicardia é um efeito adverso observado com freqüência, problema amenizado pela administração lenta da droga. Assim, a dexmedetomidina torna-se importante recurso adicional para a prática clínica da Anestesiologia, com possibilidade de uso em diversos tipos de pacientes e procedimentos cirúrgicos.

Métodos de alimentação alternativos para recém-nascidos prematuros

OBJETIVO: Apresentar revisão de literatura sobre o uso do copo/xícara como método alternativo de alimentação para recém-nascidos prematuros e verificar se há consenso sobre sua indicação para essa população. FONTES DE DADOS: Revisão de literatura narrativa, tendo sido selecionados artigos nas bases de dados Medline, Lilacs, SciELO e Cochrane, independentemente do ano, usando descritores específicos: alimentação artificial, recém-nascido prematuro, aleitamento materno, métodos de alimentação. SÍNTESE DOS DADOS: Apesar de alguns estudos afirmarem que o método do copo/xícara é eficaz e seguro para alimentar recém-nascidos pré-termo e a termo, tais estudos não avaliam de forma objetiva o efeito do método sobre a deglutição desses pacientes. CONCLUSÕES: Verificou-se não haver consenso na literatura quanto à complementação da alimentação de recém-nascidos prematuros por meio do copo/xícara. Estudos controlados devem ser realizados com a finalidade de rever riscos e benefícios do uso de métodos alternativos na alimentação do recém-nascido prematuro.

Diagnose foliar da gravioleira (Annona muricata L.): efeito da posição de ramos e folhas

A carência de informações na literatura sobre a amostragem de folhas da gravioleira, particularmente, a definição da posição da folha na copa das árvores e das folhas nos ramos ainda é um fator limitante para a diagnose foliar dessa cultura. Objetivando determinar a parte da planta indicada para a amostragem de folhas e a avaliação do estado nutricional da gravioleira conduziu-se um experimento no Campo Experimental da Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) Agroindústria Tropical, em Pacajus (CE), no período de março a abril de 2003. Colheram-se folhas de três posições da copa (terço superior, terço médio e terço inferior) e três posições no ramo (folhas da parte apical, mediana e basal) e determinaram-se os teores de P, K, Ca, Mg, S, Fe, Cu, Zn e Mn. Os resultados permitem sugerir que os teores de minerais das folhas da parte mediana da copa das árvores e na posição mediana do ramo refletem melhor o estado nutricional da frutífera.

Escuta analítica no hospital geral: : implicações com o desejo do analista

Partindo da experiência na enfermaria de um hospital-escola1, do confronto com o status-quo do trabalho dos psicólogos em hospitais e da avaliação da literatura sobre a clínica psicanalítica em hospital, esta pesquisa se propôs a buscar avanços frente a uma questão específica: a escuta psicanalítica no trabalho em enfermarias de hospital geral e as implicações dessa prática com o desejo do psicanalista. Foram entrevistados quinze psicólogos declaradamente de orientação psicanalítica, vinculados a unidades de internação e com experiência mínima de dois anos de trabalho em hospital geral. As entrevistas foram abertas e semi-estruturadas, com o intuito de contemplar de maneira uniforme a coleta de informações de cunho mais objetivo, assim como de facilitar a pertinência ao tema de estudo. A interpretação dos dados foi realizada à luz do referencial clínico psicanalítico (freud-lacaniano), sendo que tal interpretação nos permitiu identificar uma importante interação entre os impasses, presentes na instituição hospitalar, da prática clínica psicanalítica com questões pessoais e de formação do profissional, interação que se vincula à postura de trabalho adotada no hospital. Reafirmamos, através desta pesquisa, a possibilidade de fazer uso de uma escuta analítica no trabalho com pacientes internados, a qual está sempre voltada para as manifestações do inconsciente ao longo da fala, e na qual a direção do tratamento é a emergência do sujeito do inconsciente.

Seroprevalence of Toxoplasma gondii and Neospora caninum in captive maned wolves (Chrysocyon brachyurus) from southeastern and midwestern regions of Brazil

The main purpose of the present study was to investigate the occurrence of antibodies against T gondii and N. caninum in captive maned wolves from Brazil, considering that little information is available at the literature about infections by these parasites in this wild animal. Serum samples were obtained from 59 maned wolves originated from six zoos and from one ecological reserve of the southeastern and midwestern regions of Brazil. To detect IgG antibodies against T gondii, an ELISA protocol was used and the results were expressed as ELISA reactivity indexes (131). Serology for N. caninum was carried out by indirect fluorescent antibody test (IFAT) and cut-off titers were established at 1:25 dilution. From the total of the analyzed samples, 44 (74.6%) were seropositive for T gondii and only 5 (8.5%) for N. caninum. Seropositivity for T gondii ranged from 0 to 100% in the seven different origin locals, with rates over 50% among the six zoos, whereas no positivity was found in the samples from ecological reserve. For N. caninum, seroprevalence varied from 0 to 50% in the different locals, with the highest rates also detected in zoos. Seroprevalence for T gondii was strongly related with age, with rates significantly higher among adult wolves (91.7%) when compared to newborn or young animals. Seropositive samples for N. caninum were found predominantly in adult wolves. For both parasites, seroprevalence did not show a significant distinction in relation to gender. Although seroprevalence for T gondii was significantly higher when compared to N. caninum in the Brazilian captive maned wolves tested, these findings reflect the great exposure of this species to T gondii and, in lower extension, to N. caninum. Also, the present study demonstrated for the first time the presence of antibodies to N. caninum in wild life from South America. (C) 2004 Elsevier B.V. All rights reserved.

Effects of maturation and scarification on seed germination of Syagrus schizophylla (Mart.) glass. (Arecaceae)

Syagrus schizophylla (Mart.) Glass. belongs to the Arecaccae family. This palm is native of Brazil and presents great potential for use in gardens and cultivation in pot. Palms species, with relatively few exceptions, can only be propagated from seeds; even so, there are no reports in the literature about the germination of this palm seeds. The seed maturity is a factor that interferes in the success of the germination process. For some species, studies showed that palm seeds germinated better when the fruits were completely ripe (showing full color) and for other, when they were with green coloration. Several species of the Arecaccae family presents physical dormancy of seeds in varied degrees, demanding treatments for improve germination. The objective of this work was to study the effects of maturation and of the scarification on seed germination of S. schizophylla. The experimental design used was a factorial 3 x 2 (3 maturation stadiums: green, half-ripe - yellow and completely ripe - red; and mechanical scarification: with and without), entirely casualized, with four replications of 15 seeds per plot. The seeds (with 32,43% of humidity) were placed in plastic boxes with sand (60% of humidity, placing water according to weight in each three days), under controlled conditions of alternated temperature of 25-35 degrees C, photoperiod of 12 hours. The percentage of germination and the speed germination index (SGI) were evaluated until 79 days. It was observed that, so much for germination percentage as for SGI, there was not significant difference for the interaction among the two factors, maturation stadium and scarification, however, there were significant differences among the maturation stadiums and between seeds scarified or not. The seeds from green fruits presented lower germination percentage and slower germination when compared with seeds from yellow or red fruits; the seeds from yellow or red fruits didn't differ statistically to each other. To seeds scarificated, independently of the maturation stadium, presented germination percentage significantly larger and the germination was significantly faster when compared with the seeds without scarification.

Solids rheology for dehydrated food and biological materials

Mechanical properties of food products and biological materials are greatly affected by the drying process and are considered one of the most important quality attributes of dehydrated products. The aim of this work was to review theoretical principles and mathematical modeling, analyzing the measurement techniques and major experimental results that exist in the literature about rheological properties of dehydrated foods and biological materials. Different methods of measuring rheological parameters (fundamental and empiric or imitative) are discussed and major experimental results, as well as the rheological models used in their analysis, published in recent years are presented.

Microscopic characterization of teeth of pacas bred in captivity (Agouti paca, Linnaeus, 1766)

The microscopic description of the teeth of pacas (Agouti paca) bred in captivity was developed for providing biological data on one of the largest American wild rodents, as not many references exist in the literature about this species. Two newborn males, two adult males (9 and 72 months old), one newborn female and two adult females (30 and 54 months old) were used after death due to fights, neonatal cannibalism or unknown causes. Animals were radiographed, and their teeth were extracted and put on an acrylic resin block, cut on a diamond-like disc microtome and diaphanized. It was noted that enamel surrounds the coronary dentine and projects to the root region, besides being present as internal laminae, arranged in a parallel way and in the vestibulolingual direction. The dentine is located between the enamel laminae and surrounds the pulp horns. The cementum is located internal to the enamel laminae. From scanning electronic microscopy, we find that the enamel is the outer element on the vestibular surface, and it is in direct contact with the dentine. on the lingual surface, the cementum and dentine are the outer elements.

Effect of root canal filling material and level of surgical injury on periodontal healing in dogs

Some divergencies in the literature about periodontal healing after surgical injury stimulated the development of this experiment. The root canals of dogs' teeth were negotiated and filled by the lateral condensation technique with two kinds of sealers: Sealapex and zinc oxide-eugenol cement. In the second session, the bone tissue was exposed and one cavity was made at the apical third of the root and another at the border between the coronal and middle thirds, both penetrating into the root canal. Six months later the animals were sacrificed and the specimens prepared for histopathologic analysis. The results showed that the kind of filling material and the level of the periodontal wound exposing the root canal can influence the healing process (P<0.01).

Effect of temperature on seed germination of queen palm Syagrus romanzoffiana (Cham.) glassman (Arecaceae)

The Syagrus romanzoffiana is a specie of the Arecaccae family, native of Brazil, frequently used in landscape architecture. Its propagation is by seeds, however, there is little information in the literature about seed germination of this ornamental palm. The objective of this work was to study the effects of temperatures on seed germination of Syagrus romanzoffliana. The experimental design used was entirely randomized, with six temperatures (20 degrees C, 25 degrees C, 30 degrees C and 35 degrees C, constant and 20-30 degrees C and 25-35 degrees C alternated), photoperiod of 12 hours, and five replications of 20 seeds each. The seeds were placed in plastic boxes with sand, counting daily germination until 43(th) day. The percentage of seed germination (43(th) day) and the speed germination index (SGI) were evaluated. The conclusion was that there was no germination at a constant temperature of 20 degrees C and in the alternated temperature of 20-30 degrees C; the higher germination percentages were verified in the constant temperatures of 30 degrees C and 35 degrees C that didn't differ statistically from the temperature of 25-35 degrees C. The germination was faster at a constant temperature of 30 degrees C.

Fatores genéticos na psoríase glossite migratória benígna: Revisão da literatura sobre a associação com o complexe HLA

The genetics of psoriasis and benign migratory glossitis has relationship with the major HLA. The authors reviewed the literature about the association between HLA with psoriasis and benign migratory glossitis. HLA-Cw6 presents a particularly strong association, irrespective of different racial or ethnic groups, suggesting that Cw6 itself, or a closely linked gene in strong linkage disequilibrium, is the major HLA-linked susceptibility gene for psoriasis. The white Brazilian population shows the established associations between psoriasis and the HLA antigens Cw6, B13 and B17 reported in several Caucasian populations, and shows association between benign migratory glossitis and HLA-Cw6.

Familial malignant osteopetrosis in children: A case report

The clinical, radiological, pathological and laboratory findings of two brothers with autosomal recessive malignant osteopetrosis are presented. Our findings are similar to characteristics previously reported in the literature about patients with osteopetrosis. The 6-year-old male patient was pale and had petechiae on his arms and legs. He also had macrocephalia, splenomegaly, severe pancytopenia, genu valgus, hypocalcemia, amaurosis, cessation of physical development, generalized bone sclerosis and recurrent infections with a history of multiple incidences of acute otitis media. Generalized bone sclerosis and irregular sclerosis of the maxilla and mandible were seen on radiographs. The oral mucosa was apparently normal but permanent tooth eruption was delayed although there was early loss of deciduous teeth. The recommended treatment was blood transfusion and therapy with antibiotics when necessary; a bone marrow transplant was not possible due to lack of a compatible donor.

Sucessão sedimentar do Grupo Bauru na região de Pirapozinho (SP)

There is yet enthusiastic debate in the literature about the environmental conditions that originated the Cretaceous deposits of the Bauru Group, despite many authors accept that arid climatic conditions widely dominant at the base, evolved to chiefly fluvial-lacustrine conditions at the intermediate portion, and to arid conditions again at the top of the unit. The Bauru Group covers an area of about 117.000 km 2 of the Paraná Basin in São Paulo State territory. Core samples of this lithostratigraphic unit collected from a drill hole at Pirapozinho (Southwest of the São Paulo State) are described and together with well log data brought new information that do not agree with the described model. It was identified in this well the Caiuá, Pirapozinho, Santo Anastácio, Araçatuba and Adamantina formations. The study of these core samples clearly showed the dominance of hydrodynamic sedimentary structures and high to medium intensity of bioturbation in whole profile. These characteristics observed in core samples and compared to patterns of geophysical logs testify the dominance of fluvial processes in the Bauru Group deposition at the studied area. These new data suggests that the paleo-environmental evolution of the unit was much more complex, showing strong lateral and vertical changes that diverges from the model more widely accepted in the literature.

Cross-hole and seismic CPT tests in a tropical soil site

A large portion of Brazil is covered with tropical soils but literature about dynamic parameters of these soils is very limited. SCPT and cross-hole tests were carried out at an experimental research site inland in the state of São Paulo, Brazil. Shear wave velocities (VS) determined based on both tests are presented and compared. A good agreement was observed between both test results and the differences can be associated with soil variability, which was very sensitive to CPT tests. It was also observed that Go/q c ratio determined based on SCPT appears to be an interesting technique to help identify tropical soils. Copyright ASCE 2006.

Chemometric analysis of Hymenoptera toxins and defensins: A model for predicting the biological activity of novel peptides from venoms and hemolymph

When searching for prospective novel peptides, it is difficult to determine the biological activity of a peptide based only on its sequence. The trial and error approach is generally laborious, expensive and time consuming due to the large number of different experimental setups required to cover a reasonable number of biological assays. To simulate a virtual model for Hymenoptera insects, 166 peptides were selected from the venoms and hemolymphs of wasps, bees and ants and applied to a mathematical model of multivariate analysis, with nine different chemometric components: GRAVY, aliphaticity index, number of disulfide bonds, total residues, net charge, pI value, Boman index, percentage of alpha helix, and flexibility prediction. Principal component analysis (PCA) with non-linear iterative projections by alternating least-squares (NIPALS) algorithm was performed, without including any information about the biological activity of the peptides. This analysis permitted the grouping of peptides in a way that strongly correlated to the biological function of the peptides. Six different groupings were observed, which seemed to correspond to the following groups: chemotactic peptides, mastoparans, tachykinins, kinins, antibiotic peptides, and a group of long peptides with one or two disulfide bonds and with biological activities that are not yet clearly defined. The partial overlap between the mastoparans group and the chemotactic peptides, tachykinins, kinins and antibiotic peptides in the PCA score plot may be used to explain the frequent reports in the literature about the multifunctionality of some of these peptides. The mathematical model used in the present investigation can be used to predict the biological activities of novel peptides in this system, and it may also be easily applied to other biological systems. © 2011 Elsevier Inc.