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Determining reference concentrations in rivers and streams is an important tool for environmental management. Reference conditions for eutrophication-related water variables are unavailable for Brazilian freshwaters. We aimed to establish reference baselines for So Paulo State tropical rivers and streams for total phosphorus (TP) and nitrogen (TN), nitrogen-ammonia (NH(4) (+)) and Biochemical Oxygen Demand (BOD) through the best professional judgment and the trisection methods. Data from 319 sites monitored by the So Paulo State Environmental Company (2005 to 2009) and from the 22 Water Resources Management Units in So Paulo State were assessed (N = 27,131). We verified that data from different management units dominated by similar land cover could be analyzed together (Analysis of Variance, P = 0.504). Cumulative frequency diagrams showed that industrialized management units were characterized by the worst water quality (e.g. average TP of 0.51 mg/L), followed by agricultural watersheds. TN and NH(4) (+) were associated with urban percentages and population density (Spearman Rank Correlation Test, P < 0.05). Best professional judgment and trisection (median of lower third of all sites) methods for determining reference concentrations showed agreement: 0.03 & 0.04 mg/L (TP), 0.31 & 0.34 mg/L (TN), 0.06 & 0.10 mg-N/L (NH(4) (+)) and 2 & 2 mg/L (BOD), respectively. Our reference concentrations were similar to TP and TN reference values proposed for temperate water bodies. These baselines can help with water management in So Paulo State, as well as providing some of the first such information for tropical ecosystems.

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The purpose of this study was to develop a method for the stereoselective analysis of thioridazine-2-sulfoxide (THD-2-SO) and thioridazine-5-sulfoxide (THD-5-SO) in culture medium and to study the biotransformation of rac-thioridazine (THD) by some endophytic fungi. The simultaneous resolution of THD-2-SO and THD-5-SO diastereoisomers was performed on a CHIRALPAK(R) AS column using a mobile phase of hexane: ethanol: methanol (92:6:2, v/v/v) + 0.5% diethylamine; UV detection was carried out at 262 nm. Diethyl ether was used as extractor solvent. The validated method was used to evaluate the biotransformation of THD by 12 endophytic fungi isolated from Tithonia diversifolia, Viguiera arenaria and Viguiera robusta. Among the 12 fungi evaluated, 4 of them deserve prominence for presenting an evidenced stereoselective biotransformation potential: Phomopsis sp. (TD2) presented greater mono-2-sulfoxidation to the form (S)-(SE) (12.1%); Glomerella cingulata (VA1) presented greater mono-5-sulfoxidation to the forms (S)-(SE) + (R)-(FE) (10.5%); Diaporthe phaseolorum (VR4) presented greater mono-2-sulfoxidation to the forms (S)-(SE) and (R)-(FE) (84.4% and 82.5%, respectively) and Aspergillus fumigatus (VR12) presented greater mono-2-sulfoxidation to the forms (S)-(SE) and (R)-(SE) (31.5% and 34.4%, respectively). (C) 2007 Elsevier B.V. All rights reserved.

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Objectives: Resternotomy is a common part of cardiac surgical practice. Associated with resternotomy are the risks of cardiac injury and catastrophic hemorrhage and the subsequent elevated morbidity and mortality in the operating room or during the postoperative period. The technique of direct vision resternotomy is safe and has fewer, if any, serious cardiac injuries. The technique, the reduced need for groin cannulation and the overall low operative mortality and morbidity are the focus of this restrospective analysis. Methods: The records of 495 patients undergoing 546 resternotomies over a 21-year period to January 2000 were reviewed. All consecutive reoperations by the one surgeon comprised patients over the age of 20 at first resternotomy: M:F 343:203, mean age 57 years (range 20 to 85, median age 60). The mean NYHA grade was 2.3 [with 67 patients (1), 273 (11),159 (111), 43 (IV), and 4 (V classification)] with elective reoperation in 94.6%. Cardiac injury was graded into five groups and the incidence and reasons for groin cannulation estimated. The morbidity and mortality as a result of the reoperation and resternotomy were assessed. Results: The hospital/30 day mortality was 2.9% (95% Cl: 1.6%-4.4%) (16 deaths) over the 21 years. First (481), second (53), and third (12) resternotomies produced 307 uncomplicated technical reopenings, 203 slower but uncomplicated procedures, 9 minor superficial cardiac lacerations, and no moderate or severe cardiac injuries. Direct vision resternotomy is crystalized into the principle that only adhesions that are visualized from below are divided and only sternal bone that is freed of adhesions is sewn. Groin exposure was never performed prophylactically for resternotomy. Fourteen patients (2.6%) had such cannulation for aortic dissection/aneurysm (9 patients), excessive sternal adherence of cardiac structures (3 patients), presurgery cardiac arrest (1 patient), and high aortic cannulation desired and not possible (1 patient). The average postop blood loss was 594 mL (95% CI:558-631) in the first 12 hours. The need to return to the operating room for control of excessive bleeding was 2% (11 patients). Blood transfusion was given in 65% of the resternotomy procedures over the 21 years (mean 854 mL 95% Cl 765-945 mL) and 41% over the last 5 years. Conclusions: The technique of direct vision resternotomy has been associated with zero moderate or major cardiac injury/catastrophic hemorrhage at reoperation. Few patients have required groin cannulation. In the postoperative period, there was acceptable blood loss, transfusion rates, reduced morbidity, and moderate low mortality for this potentially high risk group.

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Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

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Background: Perioperative complications following robotic-assisted radical prostatectomy (RARP) have been previously reported in recent series. Few studies, however, have used standardized systems to classify surgical complications, and that inconsistency has hampered accurate comparisons between different series or surgical approaches. Objective: To assess trends in the incidence and to classify perioperative surgical complications following RARP in 2500 consecutive patients. Design, setting, and participants: We analyzed 2500 patients who underwent RARP for treatment of clinically localized prostate cancer (PCa) from August 2002 to February 2009. Data were prospectively collected in a customized database and retrospectively analyzed. Intervention: All patients underwent RARP performed by a single surgeon. Measurements: The data were collected prospectively in a customized database. Complications were classified using the Clavien grading system. To evaluate trends regarding complications and radiologic anastomotic leaks, we compared eight groups of 300 patients each, categorized according the surgeon`s experience (number of cases). Results and limitations: Our median operative time was 90 min (interquartile range [IQR]: 75-100 min). The median estimated blood loss was 100 ml (IQR: 100-150 ml). Our conversion rate was 0.08%, comprising two procedures converted to standard laparoscopy due to robot malfunction. One hundred and forty complications were observed in 127 patients (5.08%). The following percentages of patients presented graded complications: grade 1, 2.24%; grade 2, 1.8%; grade 3a, 0.08%; grade 3b, 0.48%; grade 4a, 0.40%. There were no cases of multiple organ dysfunction or death (grades 4b and 5). There were significant decreases in the overall complication rates (p = 0.0034) and in the number of anastomotic leaks (p < 0.001) as the surgeon`s experience increased. Conclusions: RARP is a safe option for treatment of clinically localized PCa, presenting low complication rates in experienced hands. Although the robotic system provides the surgeon with enhanced vision and dexterity, proficiency is only accomplished with consistent surgical volume; complication rates demonstrated a tendency to decrease as the surgeon`s experience increased. (C) 2010 European Association of Urology. Published by Elsevier B. V. All rights reserved.

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PURPOSE: To propose an analytic framework for ocular fundus alterations in late-stage Vogt,Koyanagi-Harada (VKH) disease, to describe the characteristics of overall retinal function as measured with full field electroretinography (ERG), and to correlate the intensity of the fundus changes with full-field ERG alterations and to stratify patients accordingly. DESIGN: Cross-sectional case series. METHODS: Forty-seven eyes of 26 patients with late, stage VKH disease (> 6 months past disease onset) followed-up at the University of Sao Paulo School of Medicine underwent fundus photography within 2 months of a full,field ERG examination, both according to pre-defined protocols. Fundus pictures were evaluated by two observers regarding diffuse fundus depigmentation, nummular lesions, pigment clumps, and subretinal fibrosis, and an overall analysis classified the fundus changes as mild, moderate, or severe. Full field ERG results were analyzed according to fundus-based stratification and also were stratified into 3 groups solely on the basis of decreasing amplitudes (ERG based or cluster stratification). The concordance between fundus-based and full-field ERG-based stratification strategies was estimated. RESULTS: Overall fundus grading showed substantial interobserver concordance (kappa = 0.78). Comparison of full field ERG parameters of the three fundus based stratified groups showed diffusely diminished amplitudes with preservation of implicit times (P < .05). Fundus-based and full-field ERG-based stratification strategies also showed substantial concordance (kappa = 0.68). CONCLUSIONS: The analytic framework for fundus findings proposed in this study seems reproducible and useful, because the severity categories do correlate with retinal function as measured by full-field ERG. This system may allow more precise exchange of information between practitioners as well as researchers with regard to identifying patients with greater retinal compromise rapidly as well as in comparison of outcomes of different treatment regimens. (Am J Ophthalmol 2009;148: 939-945. (C) 2009 by Elsevier Inc. All rights reserved.)

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Objective: The purpose of this study was to investigate the reliability and validity of photogrammetry in measuring the lateral spinal inclination angles. Methods: Forty subjects (32 female and 8 males) with a mean age of 23.4 +/- 11.2 years had their scoliosis evaluated by radiographs of their trunk, determined by the Cobb angle method, and by photogrammetry. The statistical methods used included Cronbach alpha, Pearson/Spearman correlation coefficients, and regression analyses. Results: The Cronbach a values showed that the photogrammetric measures showed high internal consistency, which indicated that the sample was bias free. The radiograph method showed to be more precise with intrarater reliabilities of 0.936, 0.975, and 0.945 for the thoracic, lumbar, and thoracolumbar curves, respectively, and interrater reliabilities of 0.942 and 0.879 for the angular measures of the thoracic and thoracolumbar segments, respectively. The regression analyses revealed a high determination coefficient although limited to the adjusted linear model between the radiographic and photographic measures. It was found that with more severe scoliosis, the lateral curve measures obtained with the photogrammetry were for the thoracic and lumbar regions (R = 0.619 and 0.551). Conclusions: The photogrammetric measures were found to be reproducible in this study and could be used as Supplementary information to decrease the number of radiographs necessary for the monitoring of scoliosis. (J Manipulative Physiol Ther 2009;32:423-430)

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The present work studied the adverse effects of maternal exposure of rats to alcohol during lactation, on the development of their offspring. Histometric evaluation by karyometry and of the alveolar bone at the level of the first upper molar of the sucking was perfomed. Two groups of animals, one coming from mothers exposed to drinking water containing 20% ethanol during the total lactation period and the other of controls coming from mothers receiving only alcohol-free drinking water during this period. On the 21 first day of lactation the young of each group were aleatorily selected and following anesthesia, their heads severed; after histological treatment, serial 6 mu m sections on the frontal plane at the molar level, stained with hematoxilin and eosin, were obtained. The experimental results produced, suggest that sucking from ethanol-treated mothers, show retarded post-natal growth, their alveolar bones presenting scarce, little calcified trabeculae, and a more abundant bone marrow compared to controls.

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There is evidence that several fibroblast growth factors (FGFs) are involved in growth and development of the corpus luteum (CL), but many FGFs have not been investigated in this tissue, including FGF10. The objective of this study was to determine if FGF10 and its receptor (FGFR2B) are expressed in the CL. Bovine CL were collected from an abattoir and classed as corpus hemorrhagica (stage 1), developing (stage 11), developed (stage 111), and regressed (stage IV) CL. Expression of FGF10 and FGFR2B mRNA was measured by reverse transcription-polymerase chain reaction (RT-PCR). Both genes were expressed in bovine CL, and FGF10 expression did not differ between stages of CL development. FGF10 protein was localized to large and small luteal cells by immunohistochemistry. FGFR2B expression was approximately threefold higher in regressed compared to developing and developed CL (P < 0.05). To determine if FGF10 and FGFR2B expression is regulated during functional luteolysis, cattle were injected with PGF2 alpha and CL collected at 0, 0.5, 2, 4, 12, 24, 48, and 64 hr thereafter (n = 5 CL/time point), and mRNA abundance was measured by real-time RT-PCR. FGF10 mRNA expression did not change during functional luteolysis, whereas FGFR2B mRNA abundance decreased significantly at 2, 4, and 12 hr after PGF2a, and returned to pretreatment levels for the period 24-64 hr post-PGF2 alpha. These data suggest a potential role for FGFR2B signaling during structural luteolysis in bovine CL.

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Buscando a excel??ncia dos seus servi??os, a Divis??o de Contabilidade da Superintend??ncia do INSS, no Estado de S??o Paulo, implementou a experi??ncia denominada Gest??o Estrat??gica Social, que compreende duas partes: Avalia????o econ??mica e Aperfei??oamento pessoal e profissional do servidor. A Avalia????o Econ??mica permitiu a mensura????o das atividades desenvolvidas no INSS-SP quanto aos aspectos financeiros, or??ament??rios, cont??beis e administrativos, proporcionando um instrumento gerencial de tomada de decis??es. Ao mesmo tempo, o modelo adotado, apresentado e discutido, contribuiu para o aperfei??oamento profissional ?? medida que substituiu a percep????o parcial e fragmentada do servi??o por uma vis??o de totalidade, na qual a qualidade de cada tarefa executada assume maior import??ncia e significado. Este modelo se completou com o treinamento oferecido, voltado para Organiza????o e M??todos, a fim de instrumentalizar os esfor??os dos servidores em busca de melhores resultados

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Faringoamigdalite na população pediátrica é largamente tratada com antibióticos. OBJETIVO: Estudar a microflora presente na superfície e no núcleo de amígdalas após adenoamigdalectomia eletiva em crianças. MÉTODO: Amígdalas de 102 crianças de Trinidad foram prospectivamente estudadas por meio de culturas e identificações bacteriológicas feitas a partir de amostras das superfícies e núcleos de suas amígdalas entre 2005-2006. RESULTADOS: A partir de 360 amígdalas, foram isolados Streptococcus spp. (51,3%), Staphylococcus spp. (42,3%) e Gram-Negativos (6,4%). A identificação de estafilococos e estreptococos tanto na superfície quanto no núcleo foi semelhante (p>0,05). Encontramos mais (p<0,001) Streptococcus spp. nas superfícies (82,2%) do que nos núcleos (63,3%); a prevalência de estreptococos alfa-hemolíticos foi maior (p<0,001) do que aquela de estreptococos beta-hemolíticos nas superfícies (74,4% vs. 18,6%) do que nos núcleos (58,9% vs. 13,7%). Não houve concordância entre superfícies e núcleos com relação a estreptococos (p<0,0004) e estreptococos alfa-hemolíticos (p<0,007). Estreptococos beta-hemolíticos foram mais identificados (p<0,05) em crianças dentre 6-16 anos do que naquelas entre 1-5 anos de idade (31% e 23,8% vs 12,5% e 8%). A prevalência de S. pyogenes na superfície e no núcleo foi de (84,6% vs 70%) e (50,0% vs 25,0%) em crianças de maior faixa etária e crianças mais novas, respectivamente. Klebsiella spp. (6,6%, 2,2%), Proteus (4,4%, 4,4%) e Pseudomonas (4,4 %, 1,1%) cresceram nas superfícies e núcleos, respectivamente. CONCLUSÃO: As superfícies amigdalianas tinham mais estreptococos e estreptococos hemolíticos do que seus núcleos. Crianças mais velhas tiveram mais estreptococos beta-hemolíticos, e são altamente colonizadoras de S. pyogenes. Sugerimos estudos que investiguem os mecanismos de aderência estreptocócica em crianças de Trinidad.

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A influência de diferentes adubos e disponibilidade de água no solo foi avaliada em relação ao teor e à composição química de óleos essenciais em folhas de alpínia. O experimento foi realizado em blocos casualizados, com três repetições, em esquema de parcelas subdivididas. As parcelas corresponderam a dois limites de disponibilidade de água no solo [LDA1 - redução de 75% da capacidade total de retenção de água (CTA) - e LDA2 - redução de 50% da CTA], e as subparcelas, aos adubos: esterco bovino, cama-de-galinha, torta-de-filtro, químico e o controle não-adubado. A disponibilidade de água no solo, assim como a adubação, não influenciou no teor e na composição química de óleos essenciais aos 12 meses após o plantio. Os principais constituintes químicos (teores) dos óleos essenciais em folhas de alpínia foram: &#945;-thujeno (6,11%), &#945;-pineno (2,69%), sabineno (16,69%), β-pineno (4,64%), β-mirceno (1,76%), 1,8-cineol (19,41%) e 1-terpinen-4-ol (14,32%).

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O teor de óleo essencial e a sua composição química são características genéticas e podem ser influenciados pelo ambiente e pelo estádio de desenvolvimento ou idade da planta. Dessa forma, objetivou-se, com este trabalho, avaliar a influência da idade da planta sobre a produção e a qualidade do óleo essencial de alevante. O experimento foi conduzido em Ilhéus, BA, no período de maio a dezembro de 2009. Os tratamentos foram constituídos da colheita, em seis idades da planta (60, 90, 120, 150, 180 e 210 dias após o transplante), utilizando-se o delineamento inteiramente casualizado, com quatro repetições. O óleo essencial foi obtido por hidrodestilação, em aparelho de Clevenger modificado. A identificação dos constituintes químicos foi realizada por cromatografia gasosa acoplada ao espectrômetro de massas (CG-EM). O maior teor do óleo essencial (1%) ocorreu aos 120 dias e o maior teor dos compostos majoritários &#945;-fenchol (49,92%) e cis-mirtanol (30,03%), aos 120 e 150 dias após o transplante, respectivamente.

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Ainda que sejam considerados os aspectos de magnitude e significância, o estudo de correlações entre caracteres por si só não garante causa e efeito entre eles. Dessa forma, o objetivo deste trabalho foi desdobrar as correlações fenotípicas em seus efeitos diretos e indiretos, pela análise de trilha, considerando o perfil de carotenoides em genótipos de milho. Foram utilizados dados obtidos do ensaio nacional de cultivares de milho conduzido pela Embrapa Milho e Sorgo, no ano agrícola 2004/2005, com média de 10 genótipos em cinco ambientes. Avaliaram-se os teores de carotenoides totais (CT), &#945; e β-carotenos, luteína, zeaxantina e β-criptoxantina. A xantofila zeaxantina apresenta o maior efeito direto sobre β-caroteno. As altas correlações entre β-caroteno e carotenoides totais e entre β-caroteno e β-criptoxantina são devidas ao efeito indireto, via zeaxantina. A seleção direta de genótipos com altos teores de β-caroteno apresenta-se como a alternativa de maior efetividade, mas se outras frações de carotenoides também forem consideradas, esquemas de seleção simultânea de caracteres, por meio da utilização de índices de seleção, mostram-se mais eficientes na obtenção de genótipos com altos teores de β-caroteno do que a resposta correlacionada.

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Em termos legais, compete à Comissão de Fiscalização e Disciplina do Sindicato Nacional do Ensino Superior § Art. 15º dos Estatutos internos: "e) pronunciar-se sobre a regularidade das deliberações de quaisquer órgãos sindicais, designadamente as deliberações das assembleias e quaisquer actos eleitorais, podendo determinar a anulação de quaisquer deliberações ou eleições e, quando seja caso disso, a convocação de novas assembleias". § In legal terms, for the Commission for Supervision and Discipline of the National Higher Education § Art Union 15 of the Internal Statutes:. "E) to rule on the legality of the decisions of any trade union bodies, including the deliberations of the meetings and any elections and can determine invalidate any voting or elections and, where appropriate, to convene new meetings."