Proposal of a new technique for bile duct reconstruction after iatrogenic injury. Study in dogs and review of the literature

Purpose: Interposition of a jejunal tube between the common bile duct and duodenum. Methods: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg), were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. Results: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. Conclusion: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.

Cytomegalovirus and Toxoplasma gondii seroprevalence in a Brazilian liver transplant waiting list

Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplantation. Disseminated toxoplasmosis after liver transplantation is a rare but fatal event. Serologic screening of the donor and the recipient is essential to prophylactic management, early diagnosis and therapeutic strategies to minimize the consequences of these infections. The aim of the present study was to determine the seroprevalence of CMV and Toxoplasma gondii (TG) in a Brazilian liver transplant waiting list (LTWL). Serological data were collected from 44 candidates on the LTWL between May 2003 and November 2004. Serological investigation of antibodies IgM and IgG against CMV (anti-CMV) and TG (anti-T. gondii) was performed using fluorometry commercial kits. IgG anti-CMV was positive in 37 patients (94.9%) out of 39 available results. There were not IgM anti-CMV positive results. Out of 36 analyzed patients, 22 (61.1%) presented positive IgG anti-T. gondii and none had positive IgM anti-T. gondii. The high CMV seroprevalence among our LTWL reinforces the need for appropriate protocols to avoid related complications, like reactivation and superinfection by CMV. Environmental and drug prophylactic strategies against primary infection and reactivation, as well as early diagnosis and treatment of toxoplasmosis complications, are essential for the good outcome of transplant patients.

O uso do pneumoperitônio progressivo no pré-operatório das hérnias volumosas da parede abdominal

Context - Correction of voluminous hernias and large abdominal wall defects is a big challenge in surgical practice due to technical difficulties and the high incidence of respiratory and cardiovascular complications. Objectives - To present the authors experience with inducing progressive pneumoperitoneum preoperative to surgical treatment of voluminous hernias of the abdominal wall. Methods - Retrospective study of six patients who presented voluminous hernias of the abdominal wall and were operated after installation of a pneumoperitoneum. The procedure was performed by placing a catheter in the abdominal cavity at the level of the left hypochondrium with ambient air insufflation for 10 to 15 days. Results - Four of the six patients were female and two male. Ages ranged from 42 to 62 years. Hernia duration varied from 5 to 40 years. Four patients had incisional, one umbilical, and one inguinal hernias. Mean pneumoperitoneum time was 11.6 days. There were no complications related to pneumoperitoneum installation and maintenance. All hernias were corrected without technical difficulties. The Lichtenstein technique was used to correct the inguinal hernia, peritoneal aponeurotic transposition for one of the incisional hernias, with the rest corrected using polypropylene mesh. One death and one wall infection were observed post operatively. No recurrences were reported until now, in 4 to 36 months of follow-up. Conclusion - Preoperative progressive pneumoperitoneum is a safe and easy executed procedure, which simplifies surgery and reduces post-operative respiratory and cardiovascular complications. It is indicated for patients with hernias that have lost the right of domain in the abdominal cavity.

El mercado de tierras en dos provincias de Argentina: La Rioja y Salta

Incluye Bibliografía

Escalafón de la competitividad de los departamentos en Colombia, 2009

Incluye Bibliografía

El debate sobre el sector agropecuario mexicano en el Tratado de Libre Comercio de América del Norte

Incluye Bibliografía

Cambios de la fecundidad en Bolivia

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Necesidades básicas insatisfechas

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Félix Casaverde, violão negro: identidade e relações de poder na música da costa do Peru

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Síndrome do intestino curto e transplante intestinal: modelo experimental porcino

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Rhizoctonia solani AG-1: estrutura genética, etiologia e evolutibilidade nos agroecossitemas Brachiaria spp. e arroz na Colômbia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Variação geográfica de Osteocephalus taurinus Steindachner, 1862 (Amphibia : Anura : Hylidae)

Osteocephalus taurinus é uma espécie nominal de ampla distribuição na Amazônia e nos llanos do Orinoco. Sua grande variação morfológica indica que se trata de um complexo de espécies. O presente estudo examina a variação geográfica de vários caracteres morfológicos e morfométricos da espécie nominal, avalia a hipótese de tratar-se de fato um complexo de espécies; e testa a teoria da atual distribuição das formas, através de padrões biogeográficos, ecológicos e de regímen de precipitação já definidos. A partir de 431 espécimes estudados foram selecionadas 16 populações, nas quais foram analisados 20 caracteres anatômicos internos, 14 caracteres morfométricos e seis caracteres morfológicos externos. Através de análises estatística e mapas de isolinhas evidenciou-se que O. taurinus não se trata de um complexo de espécies e sim possui uma grande variação intra e interpopulacional das caraterísticas morfométricas e morfológicas. Simultaneamente, foram observados caracteres anatômicos internos polimórficos. O primeiro componente obtido através de uma análise de componentes principais mostra uma variação clinal do tamanho corporal ao longo da distribuição geográfica total, mais evidente nos machos. Em outros caracteres analisados, a variação fico independente do cline. O padrão espacial do tamanho indicou que as formas maiores ocorrem nas terras baixas da Amazônia, onde a vegetação de floresta ombrofila divide as áreas de cerrado ao norte e ao sul do continente sul americano. Nestas últimas áreas, ocorrem com maior intensidade as formas menores. Esta distribuição espacial não se explicou através das divisões propostas por outros autores para Amazônia, o que pode ser devido a um mascaramento gerado pela grande variação intrapopulacional. O modelo espacial do tamanho corporal de O. taurinus não corresponde a um padrão de isolamento por distância, o que pode sugerir que a colonização da espécie em algumas áreas seja recente. Este estudo confirma a hipótese da origem do gênero no início do Plioceno, o que indica que O. taurinus teria tido tempo suficiente para se dispersar antes do surgimento dos Andes como barreira geográfica.

Dopplervelocimetria nas gestações complicadas por hiperglicemia: curva do índice de pulsatilidade da artéria umbilical

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Estrutura genética de populações de Rhizoctonia oryzae-sativae do arroz em São Paulo, Brasil, e em meta, Colômbia, e potencial adaptativo do patógeno à Urochloa spp

Pós-graduação em Agronomia - FEIS