Management of tracheobronchial foreign body in children

To study cases of foreign bodies (FB) in the tracheobronchial tree investigating the clinical and radiological FB characteristics, complications and endoscopic and surgical intervention. Medical and radiological records review of all FB aspiration cases treated at S (a) over tilde uo Paulo State University Hospital over the last 30 years. One hundred and sixty-four FB cases were analyzed; 57% were male, 84% of these were under 16 years old. The most common clinical manifestations were coughing (68.3%) and choking (54.9%). The most common FBs were seeds (peanut, bean, maize) and also small metal or plastic objects. Radiography was normal in 21.3%, atelectasis was present in 40.9%, hyperinsufflation in 17.1% and the FB was radio-opaque in 20.7%. FB time in the bronchial tree varied from hours to years. The most serious complications, as fibroatelectasis and difficult resolution pneumonia, were caused by the long time that the FB remained in the bronchial tree. FB extraction was by endoscopy in 89% of cases, while 6% required surgical extraction or resection of destroyed part of lung, and 5% spontaneously eliminated the FB. There was no mortality in this series. Coughing and choking were the commonest clinical findings. Most FBs were dried seeds. Complications were due to delays in diagnosis, and most would not have existed if the doctor had given credence to the history. Radiography can be normal as most FBs are radiotransparent. FB extraction was by endoscopy, but a few cases required surgery and others were spontaneously eliminated.

DNA damage in cytologically normal urothelial cells of patients with a history of urothelial cell carcinoma

In order to determine if patients with a history of previous urothelial cell carcinoma (UCC) but with current normal urinary cytology have DNA damage in urothelial cells, the single-cell gel electrophoresis (comet) assay was conducted with cells obtained by urinary bladder washings from 44 patients (28 with a history of previous UCC). Increased DNA damage was observed in cytologically normal urothelial cells of patients with a history of UCC when compared with referents with no similar history and after correcting the data for smoking status and age (P < 0.018). Increased DNA damage also correlated with the highest tumor grade, irrespective of time or course of the disease after clinical intervention (Kendall tau correlation, 0.37, P = 0.016). Moreover, aneuploidy, as assessed by DNA content ratio (DCR; 75th/25th percentile of total DNA fluorescence of 50 comets/patient) was unaltered by smoking status, but increased with UCC grade: 1.39 +/- 0.12 (median +/- 95% confidence interval; referents); 1.43 +/- 0.11 (Grade I UCC; P = 0.264, against referents); 1.49 +/- 0.16 (Grade II UCC; P = 0.057); 1.57 +/- 0.16 (Grade III UCC; P = 0.003). Micronucleated urothelial cells (MNC) were also scored on Giemsa-stained routine cytological smears and were found not to correlate with DNA damage or DCR. MNC frequencies were higher for patients with a history of UCC and/or smoking than referents with neither history, but there was no statistical difference between groups. Taken together, these results suggest that the normal-appearing urothelium of patients resected for UCC still harbor genetically unstable cells. (C) 2002 Wiley-Liss, Inc.

Natural history of the South American water snake Helicops leopardinus (Colubridae : Hydropsini) in the pantanal, Central Brazil

The South American water snake Helicops leopardinus is very abundant in the Pantanal wetlands of Central Brazil. We studied the biology of this species based on specimens collected by local workers in the Paraguay River. Females attained greater body lengths and had larger heads than males, but the latter had longer tails. Helicops leopardinus fed on a wide variety of fishes (70% of the total prey items) and frogs, with fishes of the order Gymnotiformes (33.34%) and frogs of the family Hylidae (23.34%) representing the most common prey items. There was relatively lows diet overlap between the sexes and between juveniles and adults. Mean litter size was 6.6 and ranged from 4-11. The reproductive cycle was seasonal, with birth occurring late in the wet season (simultaneous with the flooding of the Paraguay River), facilitating dispersal of young snakes by floating vegetation. Floating vegetation may be a critical habitat for H. leopardinus, and management plans for their maintenance need to be developed.

Aggressive management of orbital meningeal melanocytoma

Objective. Meningeal melanocytoma generally occurs in the posterior fossa. Orbital manifestation is rarely encountered.Methods. A thirty-five year-old man presented with progressive proptosis of his right eye. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) of the brain showed an expansive intraconal mass lesion occupying the superior orbital compartment, the entire orbital apex, and the optic foramen. Histological analysis and Immunohistochical staining for S-100 and HMB-45 monoclonal antibodies confirmed melanocytoma.Findings. Microsurgical removal was accomplished through a fronto-orbital craniotomy. Chemotherapy and irradiation followed the initial intervention. The patient returned for follow up two years after surgery, complaining of headache and right visual loss. A subfrontal tumor with massive edema was found on follow up CT scan.Interpretation. Meningeal melanocytomas are rare benign pigmented tumors of the central nervous system. They are predominant in the posterior fossa and spinal cord and frequently mistaken for melanomas, especially on frozen sections. Orbital presentation is rare. The natural history is poorly defined.

Pb-210-derived chronology in sediment cores evidencing the anthropogenic occupation history at Corumbata River basin, Brazil

Activity profiles of excess Pb-210 combined with chemical data determined in two sediment cores from Corumbatai River basin, São Paulo State, Brazil, provided new insights into the reconstruction of historical inputs of anthropogenic constituents, contributing to improving management strategies of the hydrological resources in the basin since most of the municipalities extensively utilize the waters of Corumbatai River and tributaries for drinking purposes, among other uses. Excellent significant relationships between loss on ignition (LOI) and organic matter were found for sediments of both analyzed profiles. Silica was found to be inversely related to organic matter at both analyzed profiles: its decrease accompanied an increase in the specific surface of the sediments. This relationship was confirmed by a great number of inverse significant correlations among silica and oxides Na2O, K2O, CaO, MgO, Al2O3, P2O5, Fe2O3, MnO, and TiO2. It was possible to identify the role of organic matter on adsorption of several oxides/elements in the core sediments profiles. Apparent sediment mass accumulation rates corresponding to 224 and 802 mg cm(-2) year(-1) were obtained, and are compatible with field evidence, indicating a higher value associated with sand mining activities interfering with the natural/normal sedimentation process, due to modifications of the channel drainage.

Succession and management of tropical dry forests in the Americas: Review and new perspectives

Understanding tropical forest succession is critical for the development of tropical forest conservation strategies worldwide, given that tropical secondary forests can be considered the forests of the future. Tropical dry forests (TDF) are among the most threatened tropical ecosystems, there are more secondary forests and forest restoration efforts that require a better understanding of successional processes. The main goal of this synthesis for this special issue on the ecology and management of tropical dry forests in the Americas is to present a summarized review of the current knowledge of the ecology and management implications associated to TDF succession. We explore specific issues associated to tropical dry forest succession with emphasis on the use of chronosequences, plant diversity and composition, plant phenology and remote sensing, pollination, and animal-plant interactions; all under the integrating umbrella of ecosystem succession. We also emphasize the need to conduct socio-ecological research to understand changes in land-use history and its effects on succession and forest regeneration of TDF. We close this paper with some thoughts and ideas associated with the strong need for an integrating dimension not considered until today: the role of cyberinfrastructure and eco-informatics as a tool to support sound conservation, management and understanding of TDF in the Americas. (C) 2009 Elsevier B.V. All rights reserved.

Tillage and phosphorus management effects on enzyme-labile bioactive phosphorus availability in Cerrado Oxisols

Phosphorus (P) is an essential element in crop nutrition, which can be growth limiting or an environmental contaminant, if present in excess. Tillage practices have a direct effect on the behavior and availability of soil P. Sorption and availability of various P forms were evaluated in an incubation-fractionation study of three soils, a Typic Paleudults (CR soil) and two Cerrado Oxisols (Latossolo Vermelho-Amarelo [LVA] and Latossolo Vermelho [LV]) with distinct biogeochemical characteristics and tillage management history. Phosphate and myo-inositol hexakisphosphate (mIPH) were strongly sorbed by the soils. Maximum adsorption capacities (S(max)) were 2.2-6.9, 3.3-7.8, and 1.6-19.8 mmol kg(-1) for phosphate in the 0-40 cm depths of the CR, LV, and LVA soils, respectively. For mIPH, S. were 1.2-3.7, 3.7-5.5, and 4.6-5.2 mmol kg(-1). Saturation indices reflected the long-term effect of repeated manure applications on the Paleudults and the near saturation of its P holding capacity, in contrast to the recently cultivated Cerrado soils. Tillage method appeared to have altered P retention characteristics of the near-surface zone very slightly, while increases in ligand-exchangeable (EEP;) and enzyme-labile organic P (EDTA-PHP) forms were observed in no-till Oxisols. In the Paleudults, added manure P increased bioactive P fractions and P saturation of no-till near-surface soil zone. Estimates of all bioactive P fractions using the ligand-based enzymatic assay showed it to be an effective method for assessing P availability in soil and developing sustainable P management strategies, particularly in Cerrado Oxisols that were low in organic matter while having an extensive P-fixing capacity. Published by Elsevier B.V.

Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

Resistivity piezocone for geo-environmental site characterization: Two case histories from Brazil

This paper presents two case histories from Brazil where geophysical and resistivity piezocone tests were carried out to detect contamination. At the first one, the site investigation program was carried out to detect salt-water intrusions in a superficial sedimentary aquifer, at the Paranaguá harbor, in Paraná State. The second case history is a sanitary landfill from Bauru City, São Paulo State. In both sites, superficial geophysical tests were interpreted to detect and delineate the shape of contamination plume, helping to locate the resistivity piezocone tests. It was found that the interpretation of resistivity piezocone tests is straightforward to assess salt-water intrusion in sedimentary sands. For tropical soils, this technique presented some limitations since the groundwater table sometimes is deeper than the layer penetratable to the cone. Moreover, the genesis of those soils affects soil behavior and soil and water sampling is required to support interpretation.

ENCORE: Enhanced code Galileo receiver for land management applications in Brazil

Taking benefit of the new Galileo ranging signals, the ENCORE (Enhanced Code Galileo Receiver) project aims to develop a low-cost Land Management Application to cover needs of the Brazilian market in terms of geo-referencing and rural/urban cadastre, using a low-cost Enhanced Galileo Code Receiver as baseline. Land management applications require precision and accuracy levels from a few to several decimetres that are under-met with current pseudorange-based receiver and over-met with phase observations. This situation leads either to a waste of resources, or to lack of accuracy. In this project, it is proposed to fill this gap using the new possibilities of the Galileo ranging signals, in particular E5 AltBOC and E1 CBOC. This approach reduces the cost of the end-user solution, helping the rapid penetration of Galileo technology outside Europe. ©2010 IEEE.

Classification of crucifer cultivars based on the life-history of diamondback moth (Plutella xylostella)

We compared different cultivars and hybrids of crucifers in relation to development and life-history of diamondback moth (Plutella xylostella) to classify the plants according to their resistance to the pest. The plants used were Manteiga da Geórgia kale, Bola de Neve cauliflower, Ramoso Piracicaba Precoce broccoli, Chato-de-quintal cabbage, and the hybrid cabbages Midori, TPC668, TPC308, and TPC681. We evaluated performance daily until the pupal stage. Pupae were assessed individually to determine the pupal weight, performance, and pupal period. We determined the sex ratio, fecundity, fertility, and longevity of the emerged adults and calculated their reproductive potential. Cabbage hybrids TPC668, TPC308, and TPC681 do not support the development and reproduction of the diamondback moth. These hybrids show a level of resistance that is similar to that found the commercially available hybrid Midori and cultivar Chato de Quintal, which are known to be resistant to the diamondback moth. This finding implies that the capitata (cabbage) cultivars are the most suitable for planting because they are more resistant to pest than the cultivar's moth, acephala (kale). © 2013 Copyright Taylor and Francis Group, LLC.

O processo GEO na cidade de São Paulo e a Gestão Ambiental Urbana: uma análise a partir da Política Municipal de Áreas Verdes

Pós-graduação em Geografia - IGCE

A survey of the management of patients with temporomandibular disorders by general dental practitioners in southern Brazil

Purpose: Temporomandibular disorders (TMD) are recognized as one of the mostcontroversial topics in dentistry, despite the fact that both basic science and clinicalresearchers have currently reached some degree of consensus. This study aimed toconduct a questionnaire-based survey about the management of TMD patients bygeneral dental practitioners (GDPs).Materials and Methods: One hundred fifty-one GDPs with a private practice in a cityof southern Brazil were included, independent of school of origin, gender, graduationyear, and curriculum content. All participants were administered a questionnaire aboutthe management of patients with TMD, and the responses were analyzed by binomialand chi-square tests (α = 0.05).Results: Of the GDPs, 88.7% received TMD patients, who were primarily diagnosedon the basis of medical history (36.6%) or physical examination (30.4%). Of these,65.4% referred the patients elsewhere, primarily to specialists in occlusion (36.1%) ororthodontics (29.7%). Occlusal splinting was the most commonly used managementmodality (20.8%), followed by occlusal adjustment (18.1%) and pharmacotherapy(16.6%). Splints were fabricated in maximum habitual intercuspation or centric re-lation depending on individual patient (54.8%). The hard stabilization form was themost common type of appliance used (35.0%). Moreover, 73.8% of the GDPs didnot employ semi-adjustable articulators, and 69.5% adjusted the appliances at thetime of fixing. The duration of splint use and the frequency of follow-up were con-sidered patient dependent by 62.1% and 72.8%, respectively. GDPs considered thetwo major TMD etiologic categories as multifactorial (20.8%) and occlusion (19.9%).Multidisciplinary medical and dental treatment was considered necessary by 97.9%.Conclusions: The evaluated general dental practitioners manage TMD patients ac-cording to international guidelines.

Spatiotemporal variation in life history traits of three small fishes in streams of south-eastern Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hepatitis C infection: challenges in dental management and diagnosis of extrahepatic manifestations

Hepatitis C is associated with autoimmune diseases, hepatocellular carcinoma,and extrahepatic manifestations that, in conjunction, may seriously compromise the patient's quality of life. We herein describe a case of chronic hepatitis C with oral manifestations and discuss some implications for diagnosis and treatment. A 63-year-old woman complaining of spontaneous bleeding of the oral mucosa presented with bilateral asymmetric ulcers surrounded by white papules and striae on the buccal mucosa. Her medical history revealed leucopenia, thrombocytopenia, and skin lesions associated with chronic hepatitis C. Propranolol and ranitidine had recently been prescribed. Lichen planus, lichenoid reaction, and erythema multiforme were considered in the differential diagnosis. Histopathological analysis revealed lymphocytic infiltrate in a lichenoid pattern. The lesions partially healed after 1 week and completely regressed after 6 months, despite the maintenance of all medications; no recurrence was observed. The final diagnosis was oral lichen planus associated with hepatitis C. Chronic hepatitis C may present oral manifestations, which demand adjustments in dental treatment planning. Medication side effects may interfere with the clinical presentation and course of the disease and should be accounted for in the differential diagnosis. The possibility of spontaneous remission of oral lichen planus should always be considered, especially when putative etiological factors of a lichenoid lesion are withdrawn in an attempt to differentiate oral lichen planus from lichenoid lesions. This case emphasizes the importance of recognizing the extrahepatic manifestations of hepatitis C as a cause of increased morbidity.