Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia

This study was designed to compare the variability of the onset and offset of the effect of two neuromuscular blocking drugs with different elimination pathways in adult and elderly patients during total intravenous anesthesia (TIVA). After Ethics Committee approval and patients’ informed consent, the drugs were compared in 40 adult and 40 elderly patients scheduled for elective surgery under TIVA with tracheal intubation who were randomized to receive a single bolus dose of 0.15 mg/kg cisatracurium or 0.9 mg/kg rocuronium. The time of onset of maximum depression, duration of action, and recovery index time were measured and recorded for each patient and variability is reported as means ± standard deviation. Time of onset was significantly shorter for rocuronium than cisatracurium for the adult and elderly groups (P = 0.000), but the variability of cisatracurium was significantly greater compared with rocuronium for the same age groups (93.25 vs 37.01 s in the adult group and 64.56 vs 33.75 s in the elderly group; P = 0.000). The duration of the effect in the elderly group receiving rocuronium was significantly longer than in the elderly group receiving cisatracurium, and the variability of the duration was significantly greater in the rocuronium group than in the cisatracurium group. Mean time of recovery was significantly longer for the elderly group receiving rocuronium than for the elderly group receiving cisatracurium (P = 0.022), and variability was also greater (P = 0.002). Both drugs favored good intubating conditions. In conclusion, cisatracurium showed less variability in these parameters than rocuronium, especially in the elderly, a fact that may be of particular clinical interest.

Water Erosion on an Oxisol under Integrated Crop-Forest Systems in a Transitional Area between the Amazon and Cerrado Biomes

ABSTRACT Water erosion is one of the main factors driving soil degradation, which has large economic and environmental impacts. Agricultural production systems that are able to provide soil and water conservation are of crucial importance in achieving more sustainable use of natural resources, such as soil and water. The aim of this study was to evaluate soil and water losses in different integrated production systems under natural rainfall. Experimental plots under six different land use and cover systems were established in an experimental field of Embrapa Agrossilvipastoril in Sinop, state of Mato Grosso, Brazil, in a Latossolo Vermelho-Amarelo Distrófico (Udox) with clayey texture. The treatments consisted of perennial pasture (PAS), crop-forest integration (CFI), eucalyptus plantation (EUC), soybean and corn crop succession (CRP), no ground cover (NGC), and forest (FRS). Soil losses in the treatments studied were below the soil loss limits (11.1 Mg ha-1 yr-1), with the exception of the plot under bare soil (NGC), which exhibited soil losses 30 % over the tolerance limit. Water losses on NGC, EUC, CRP, PAS, CFI and FRS were 33.8, 2.9, 2.4, 1.7, 2.4, and 0.5 % of the total rainfall during the period of study, respectively.

Comparative study for the identification of myocardial ischemia by contrast ventriculography under the effect of isosorbide mononitrate and by perfusional myocardial scintigraphy in patients with ischemic heart disease

OBJECTIVE: To evaluate and compare the usefulness of cineventriculographies, before and after nitrate use, to technetium-99m sestamibi scintigraphy for the identification of myocardial ischemia. METHODS: Twenty-six patients were studied at basal conditions and 5 minutes after intravenous administration of isosorbide mononitrate (0.3mg/kg), to evaluate the performance and regional wall motion of the left ventricle (LV). The results were compared to those obtained with technetium-99m sestamibi scintigraphy. RESULTS: Before nitrate, contrast ventriculography identified 30 normal segments, 62 hypokinetic segments, 28 dyskinetic segments, and 14 akinetic segments. After drug administration, 99 segments were normal, 11 hypokinetic, 11 dyskinetic, and 13 akinetic. Myocardial scintigraphy revealed 110 ischemic segments and 18 fibrotic segments (p<0.005). After drug administration, the ventriculography showed increase in the velocity of circumferential fiber shortening (p=0.0142), the ejection fraction (p=0.0462), decrease in the end-systolic volume (p=0.0031) and no change in end-diastolic volume. CONCLUSION: Contrast ventriculography using nitrate proved to be similar to perfusional myocardial scintigraphy in the identification of myocardial ischemia.

Spodosols pedogenesis under barreiras formation and sandbank environments in the south of Bahia

Morphologically differentiated Spodosols usually occur in the Coastal Plain of the South of Bahia and North of Espírito Santo. They are found in profiles known as "muçungas", i.e. sandy soils that accumulate water. In these areas, two kinds of Spodosols, different from those in the Restinga area, can be found: Spodosols with E albic horizon (white muçunungas) and without this horizon (black muçunungas). Eight soil profiles with spodic characteristics were collected and described in order to evaluate differences in the formation process of Barreiras and Restinga Spodosols in the South of Bahia. The soil profiles were also characterized chemically, physically and mineralogically. Additionally, texture and chemical analysis, Fe and Al extraction by sodium dithionite-citrate-bicarbonate (DBC), acid ammonium oxalate and sodium pyrophosphate, ammonium oxalate extract optic density (DOox), sulphuric acid attack, and X ray difractometry of the clay fraction were performed. In the Spodosols of the Barreiras area, fragipan was found the spodic layers. Cemented B spodic horizon were observed in the white muçunungas, and granular structure and dark color from the surface in the black muçunungas. There was no fragipan or hard spodic horizon in the Restinga Spodosol. This soil is acid, dystrophic and alic, with sandy texture and high clay percentages in the spodic horizons. The CEC, based on H + Al, is predominantly represented by the organic matter. The most representative components of the mineral phase of the clay fraction are kaolinite and possibly vermiculite traces with interlayered hydroxy. Chemical, physical, morphological and mineralogical differences were observed between the Barreiras and Restinga environments. The black and white muçunungas differ in morphologic and chemical properties only.

Changes in a Rhodic Hapludox under no-tillage and urban waste compost in the northwest of Rio Grande do Sul, Brazil

The use of urban waste compost as nutrient source in agriculture has been a subject of investigation in Brazil and elsewhere, although the effects on soil physical and chemical properties and processes are still poorly known. The aim of this study was to evaluate the effect of application of urban waste compost and mineral fertilizer on soil aggregate stability and organic carbon and total nitrogen content of a Rhodic Hapludox under no-tillage in the northwestern region of Rio Grande do Sul, Brazil, in the 2009/2010 and 2010/2011 growing seasons. The experiment was arranged in a 2 × 6 (seasons and fertilization) factorial in a randomized complete block design with four replications. The factor time consisted of two growing seasons (sunflower in 2009/10 and maize in 2010/11) and the factor fertilization of five rates of urban waste compost (0, 25, 50, 75 and 100 m³ ha-1), and mineral fertilizer. Soil samples were collected from the 0.0-0.10 m layer to determine aggregate stability (mean weight and geometric diameter), soil organic carbon (SOC) and total nitrogen (TN). Rates of up to 75 m³ ha-1 of urban waste compost, after two years of application to no-tillage maize and sunflower, improved aggregation compared to mineral fertilization in a Rhodic Hapludox. After the second crop, the SOC and TN contents increased linearly with the levels of urban waste compost.

HEAVY METALS AND MICRONUTRIENTS IN THE SOIL AND GRAPEVINE UNDER DIFFERENT IRRIGATION STRATEGIES

Soils under natural conditions have heavy metals in variable concentrations and there may be an increase in these elements as a result of the agricultural practices adopted. Transport of heavy metals in soil mainly occurs in forms dissolved in the soil solution or associated with solid particles, water being their main means of transport. In this context, the aim of this study was to evaluate the heavy metal and micronutrient content in the soil and in the grapevine plant and fruit under different irrigation strategies. The experiment was carried out in Petrolina, PE, Brazil. The treatments consisted of three irrigation strategies: full irrigation (FI), regulated deficit irrigation (RDI), and deficit irrigation (DI). During the period of grape maturation, soil samples were collected at the depths of 0-10, 10-20, 20-40, 40-60, and 60-80 cm. In addition, leaves were collected at the time of ripening of the bunches, and berries were collected at harvest. Thus, the heavy metal and micronutrient contents were determined in the soil, leaves, and berries. The heavy metal and micronutrient contents in the soil showed a stochastic pattern in relation to the different irrigation strategies. The different irrigation strategies did not affect the heavy metal and micronutrient contents in the vine leaves, and they were below the contents considered toxic to the plant. In contrast, the greater availability of water in the FI treatment favored a greater Cu content in the grape, which may be a risk to vines, causing instability and turbidity. Thus, adoption of deficit irrigation is recommended so as to avoid compromising the stability of tropical wines of the Brazilian Northeast.

Leaf and root volatiles produced by tissue cultures of Alpinia zerumbet (pers.) Burtt & Smith under the influence of different plant growth regulators

Volatiles produced by plantlets of Alpinia zerumbet were obtained by means of simultaneous distillation-extraction (SDE). The effects of indole-3-acetic acid, kinetin, thidiazuron and 6-benzylaminopurine on leaf and root volatile composition obtained by tissue cultures were investigated. A higher content of b-pinene and a lower content of sabinene were observed in leaf volatile of plantlets cultured in control, IAA and IAA+ TDZ media, as compared with those of donor plants. In vitro conditions were favorable to increase caryophyllene content. Volatile compounds from the root were characterized mainly by camphene, fenchyl-acetate and bornyl acetate; which constitute about 60% of total volatile.

Weed community and growth under the canopy of trees adapted to the brazilian semi-arid region

The objectives of this work were to evaluate the floristic composition and dry biomass of weeds under the canopy of seven perennial species adapted to the Semi-Arid region of Brazil, and correlate these characteristics with growth traits of the perennial species. The following perennial species were evaluated in two experiments (E1 and E2): mesquite (Prosopis juliflora), jucá (Caesalpinia ferrea), white popinac (Leucaena leucocephala), mofumbo (Combretum leprosum), neem (Azadirachata indica), sabiá (Mimosa caesalpiniaefolia) and tamarind (Tamarindus indica). In E1, the seven species were evaluated in a random block design with four replicates and nine plants per plot. In E2, evaluation comprised four species (mesquite, jucá, white popinac, and tamarind) in a random block design with eight replicates and nine plants per plot. A circle with an area of 1.77 m² was established around the trunk of each plant, two years after they were transplanted to the permanent location. The weeds collected within this circle were cut even with the ground, classified and weighed. At this time, plant height, and crown and stem diameters were evaluated in all trees of each plot. In E1 there were no differences between tree species as to weed frequency under their canopies; however, weed growth was smaller under the canopy of sabiá trees. Mesquite and sabiá had the greatest plant height and crown diameter means, but only sabiá had the greatest stem diameter. In E2, the perennial species were not different with regard to weed frequency and growth under their canopies, but mesquite had the greatest growth, as measured by plant height (with significant results for jucá as well) and crown and stem diameter.

Weeds under the canopies of tree species submitted to different planting densities and intercropping

Assessing the growth and floristic composition of species that grow under the canopy of trees is important for weed control (WC). The objective of this study was to assess two experiments (E1 and E2), when the trees were two years and one year of age, respectively. In E1, sabiá (S) and gliricidia (G) were submitted to planting densities from 400 to 1.200 plants ha-1. In E2, growing systems consisting of S, G, and neem (N) combinations were compared: SSS, GGG, NNN, GSG, NSN, SGS, NGN, SNS, and GNG (each letter represents a row of plants). A random block design was adopted, with three (E1) and four (E2) replicates. In E1, treatments were arranged as split-plots (species in plots). In E2, the degrees of freedom for treatments (8) were partitioned into growing systems (treatments that involved the same species) and between growing system groups (2). Twenty-one weed species were found in E1. Gliricidia attained greater plant height than sabiá, but these species did not differ in canopy diameter, number of weed species per plot, and weed green and dry biomass of the shoot. Higher planting densities resulted in the reduction of all those traits. Twenty-six weed species were found in E2. Growing systems that included gliricidia showed canopies with greater diameters than growing systems that included neem. There were no differences between growing systems for number of weed species per plot and for weed green and dry biomass of the shoot.

Leaf contents of nitrogen and phenolic compounds and their bearing with the herbivore damage to Tibouchina pulchra Cogn. (Melastomataceae), under the influence of air pollutants from industries of Cubatão, São Paulo

The Atlantic Forest on the slopes of Serra do Mar around Cubatão (São Paulo, Brazil) has been affected by massive emissions of pollutants from the local growing industrial complex. The effects of air pollution on the amounts of leaf nitrogen, total soluble phenols and total tannins of Tibouchina pulchra Cogn., a common species in the area of Cubatão, were investigated, as well as the possible influence of the altered parameters on the leaf area damaged by herbivores. Fully expanded leaves were collected at two sites: the valley of Pilões river (VP), characterized by a vegetation virtually not affected by air pollution and taken as a reference; and valley of Mogi river (VM), close to the core region of the industrial complex, and severely affected by air pollution. No differences were observed for any parameters between samples collected in the summer and winter in both sites. On the other hand, compared to VP, individuals growing in VM presented higher amounts of nitrogen and lower amounts of total soluble phenols and total tannins, as well as higher percentages of galls per leaf and higher leaf area lost to herbivores. Regression analysis revealed that the increase in leaf area lost to herbivores can be explained by the increase of the content of nitrogen and decrease in the contents of total soluble phenols and total tannins. Although significant, the coefficients of explanation found were low for all analyses, suggesting that other biotic or abiotic factors are likely to influence leaf attack by herbivores.

Photic driving in the electroencephalogram of children and adolescents: harmonic structure and relation to the resting state

In order to identify latent bioelectrical oscillators, 15 normal subjects (aged 9-17 years, 8 males, 7 females) were subjected to intermittent photic stimulation. The EEG amplitude spectra corresponding to the 11 fixed frequencies of stimulation presented (3-24 Hz) were combined to form "profiles" of the driving reaction in the right occipital area. The driving response varied with frequency, and was demonstrable in 70-100% of cases (using as criterion peak amplitudes 20% larger than those of the neighbors). The strongest responses were observed at the frequency closest to the alpha peak of the resting EEG. A secondary profile maximum was in the theta band. In 10 subjects, this maximum exceeded half the alpha peak (with an average of 72.4% of the alpha peak), while in the resting spectra, theta amplitudes were much lower than the alpha maxima. This responsiveness in theta activity seems to be characteristic of prepubertal and pubertal subjects. The profiles and resting EEG spectra showed a highly significant Pearson's correlation, with the peak in the theta band of the profiles being the main difference observed between them. The correlation coefficient was significantly correlated with the ratio of the maxima in the theta and alpha bands (R = -0.77, P<0.001). The correlation coefficient between profile and resting spectrum may be a useful indicator in screening methods used to reveal latent cerebral oscillators. Profiles for the second and third harmonics were correlated with those of the first harmonic (fundamental frequency), when considering the corresponding EEG frequencies. Peak frequencies in all three profiles were close to those of the individual's background alpha rhythm, and peak amplitudes in higher harmonics were not much lower than those of the fundamental frequency (mean values of 84 and 63%, for second and third harmonics, respectively).

Topographic aspects of photic driving in the electroencephalogram of children and adolescents

The electroencephalogram amplitude spectra at 11 fixed frequencies of intermittent photic stimulation of 3 to 24 Hz were combined into driving "profiles" for 14 scalp points in 8 male and 7 female normal subjects aged 9 to 17 years. The driving response varied over frequency and was detected in 70 to 100% of cases in the occipital areas (maximum) and in 27 to 77% of cases in the frontal areas (minimum) using as a criterion peak amplitude 20% higher than those of the neighbors. Each subject responded, on average, to 9.7 ± 1.15 intermittent photic stimulation frequencies in the right occipital area and to 6.8 ± 1.97 frequencies in the right frontal area. Most of the driving responses (in relation to the previous background) were significant according to the spectral F-test (a = 0.05), which also detected changes in some cases of low amplitude responses not revealed by the peak criterion. The profiles had two maxima in the alpha and theta bands in all leads. The latter was not present in the background spectra in the posterior areas and was less pronounced in the anterior ones. The weight of the profile theta maximum increased towards the frontal areas where the two maxima were similar, while the profile amplitudes decreased. The profiles repeated the shape of the background spectra, except for the theta band. The interhemispheric correlation between profiles was high. The theta driving detected in all areas recorded suggests a generalized influence of the theta generators in prepubertal and pubertal subjects.

Penetration resistance in a latosol under different moisture and penetration speeds

The soil penetration resistance has been used to represent the compaction situation and several authors have attempted to relate the cone index (CI) with the bulk density. The importance of using the CI as source of information for decisions in agricultural activities, livestock and forestry manner, has become increasingly larger, which requires more knowledge about the penetrometers and penetrographs behavior. This study aimed to verify, in controlled laboratory conditions, the influence of soil water content and cone penetration rate to obtain the cone index, when density variation occurs. The soil was compacted by compression through a universal press cylinder which was specially designed to produce the test specimens. Bulk densities were determined from samples taken from the test specimens and their moisture content. The CI values obtained were between 0.258 and 4.776 MPa, measured in 4 moistures and 7 soil densities with 3 penetration speeds. It was concluded that the determination of IC is strongly influenced by the soil moisture but the penetration speed variation, used in this study, was not sufficient to influence the IC determination. However, the decrease in soil water content may increase the sensitiveness to detect a variation in bulk density by the use of cone index.

Health education: the role and functions of the specialist and the generalist

Education for health is a process in which all public health and medical care personnel are involved. People learn both formally (planned learning experiences) and informally (unplanned learning experiences). Since the patient, the client, the consummer and the community expect public health and medical care personnel to assist them with health and disease issues and problems, the response of the professional "educates" the customer whether the professional intends to educate or not. Therefore, it is incumbent on all public health and medical care professionals to understand their educational functions and their role in health education. It is also important that the role of the specialist in education be clear. The specialist, as to all other specialists, has an in-depth knowledge of his area of expertise, i.e., the teaching/learning process; s/he may function as a consultant to others to enhance the educational potential of their role or s/he may work with a team or with communities or groups of patients. Specific competencies and knowledge are required of the health education specialist; and there is a body of learning and social change theory which provides a frame of reference for planning, implementing and evaluating educational programs. Working with others to enhance their potential to learn and to make informed decisions about health/disease issues is the hallmark of the health education specialist.