Direct MR arthrography of the shoulder under axial traction: Feasibility study to evaluate the superior labrum-biceps tendon complex and articular cartilage.

PURPOSE: To assess the value of adding axial traction to direct MR arthrography of the shoulder, in terms of subacromial and glenohumeral joint space widths, and coverage of the superior labrum-biceps tendon complex and articular cartilage by contrast material. MATERIALS AND METHODS: Twenty-one patients investigated by direct MR arthrography of the shoulder were prospectively included. Studies were performed with a 3 Tesla (T) unit and included a three-dimensional isotropic fat-suppressed T1-weighted gradient-recalled echo sequence, without and with axial traction (4 kg). Two radiologists independently measured the width of the subacromial, superior, and inferior glenohumeral joint spaces. They subsequently rated the amount of contrast material around the superior labrum-biceps tendon complex and between glenohumeral cartilage surfaces, using a three-point scale: 0 = no, 1 = partial, 2 = full. RESULTS: Under traction, the subacromial (Δ = 2.0 mm, P = 0.0003), superior (Δ = 0.7 mm, P = 0.0001) and inferior (Δ = 1.4 mm, P = 0.0006) glenohumeral joint space widths were all significantly increased, and both readers noted significantly more contrast material around the superior labrum-biceps tendon complex (P = 0.014), and between the superior (P = 0.001) and inferior (P = 0.025) glenohumeral cartilage surfaces. CONCLUSION: Direct MR arthrography of the shoulder under axial traction increases subacromial and glenohumeral joint space widths, and prompts better coverage of the superior labrum-biceps tendon complex and articular cartilage by contrast material. J. Magn. Reson. Imaging 2013;37:1228-1233. © 2012 Wiley Periodicals, Inc.

Pre-analytical and methodological challenges in red blood cell microparticle proteomics.

Microparticles are phospholipid vesicles shed mostly in biological fluids, such as blood or urine, by various types of cells, such as red blood cells (RBCs), platelets, lymphocytes, endothelial cells. These microparticles contain a subset of the proteome of their parent cell, and their ready availability in biological fluid has raised strong interest in their study, as they might be markers of cell damage. However, their small size as well as their particular physico-chemical properties makes them hard to detect, size, count and study by proteome analysis. In this review, we report the pre-analytical and methodological caveats that we have faced in our own research about red blood cell microparticles in the context of transfusion science, as well as examples from the literature on the proteomics of various kinds of microparticles.

Long-term treatment of eosinophilic esophagitis esophagitis with budesonide

BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic-inflammatory disease of the esophagus, characterized by esophagus-related symptoms and a dense tissue eosinophilia, both refractory to proton pump inhibitors. Topical corticosteroids have proven effective in inducing clinical and histologic remission. However, a long-term strategy for the management of this chronic disease is not yet defined. METHODS: In a randomized, double-blind, placebocontrolled, long-term trial, we evaluated the efficacy of twice-daily 0.25 mg swallowed budesonide in maintaining a remission in adult EoE with prior response to induction therapy. Pre- and post-treatment disease activity was assessed clinically, endoscopically, histologically, by immunofluorescence and by high-resolution endosonography. The primary end point was the ability to maintain histologic remission (<5 eos/hpf) of EoE in. Secondary end points were the efficacy on symptom control and on tissue remodeling as well as the determination of the safety of long-term esophageal administration of topical corticosteroids. RESULTS: During a 50-week therapy of quiescent EoE with low-dose budesonide the esophageal eosinophil load (ECP staining) increased from 1.1 to 29.9 eos/hpf, but under placebo the increase was significantly larger (0.5 to 51.1 eos/hpf; p=0.01). At the end of the studyperiod, 35.7% (5/14) of the budesonide patients were in complete and 14.3% (2/14) in partial histologic remission; with placebo no patient was in complete and 28.6% (4/14) were in partial remission (p=0.0647). The increase of the symptom score was markedly lower in budesonide- (0.79 to 2.29 points) than in placebo-patients (0.71 to 4.00 points; p=0.0875). The median time to relapse of symptoms was >125 days in the budesonide and 95 days in the placebo group (p = 0.14). Measured by high-resolution endosonography, all EoE patients had pre-treatment a highly thickened esophageal wall compared with healthy controls (3.05±1.08 mm vs. 2.18±0.35 mm; p<0.0001). Long-term topical budesonide reduced mainly the thickness of the superficial wall layers (mucosa, 0.75 mm to 0.45 mm; p=0.025) whereas the response of the deeper layers was less pronounced (submucosa 1.31 to 1.08 mm; p=0.19 and muscularis 0.82 to 0.76 mm; p=0.72). Budesonide did not evoke any mucosal atrophy. CONCLUSIONS: This study clearly demonstrates that 1) Untreated eosinophil inflammation results in an impressive remodeling of the esophagus; 2) A therapy is therefore needed; 3) The high relapse rate after short-term therapy requires a long-term management and 4) Maintenance treatment with budesonide is well tolerated and keeps half of the patients in remission.

Test of four colon cancer risk-scores in formalin fixed paraffin embedded microarray gene expression data.

BACKGROUND: Prognosis prediction for resected primary colon cancer is based on the T-stage Node Metastasis (TNM) staging system. We investigated if four well-documented gene expression risk scores can improve patient stratification. METHODS: Microarray-based versions of risk-scores were applied to a large independent cohort of 688 stage II/III tumors from the PETACC-3 trial. Prognostic value for relapse-free survival (RFS), survival after relapse (SAR), and overall survival (OS) was assessed by regression analysis. To assess improvement over a reference, prognostic model was assessed with the area under curve (AUC) of receiver operating characteristic (ROC) curves. All statistical tests were two-sided, except the AUC increase. RESULTS: All four risk scores (RSs) showed a statistically significant association (single-test, P < .0167) with OS or RFS in univariate models, but with HRs below 1.38 per interquartile range. Three scores were predictors of shorter RFS, one of shorter SAR. Each RS could only marginally improve an RFS or OS model with the known factors T-stage, N-stage, and microsatellite instability (MSI) status (AUC gains < 0.025 units). The pairwise interscore discordance was never high (maximal Spearman correlation = 0.563) A combined score showed a trend to higher prognostic value and higher AUC increase for OS (HR = 1.74, 95% confidence interval [CI] = 1.44 to 2.10, P < .001, AUC from 0.6918 to 0.7321) and RFS (HR = 1.56, 95% CI = 1.33 to 1.84, P < .001, AUC from 0.6723 to 0.6945) than any single score. CONCLUSIONS: The four tested gene expression-based risk scores provide prognostic information but contribute only marginally to improving models based on established risk factors. A combination of the risk scores might provide more robust information. Predictors of RFS and SAR might need to be different.

Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases.

Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.

Compendio metodológico para la extracción de lípidos totales a partir de Biomasa Microalgal

Lo descrito en este documento es el resultado de una serie de experiencias realizadas, así como modificaciones y adaptaciones de técnicas empleadas en diversos organismos acuáticos, con la finalidad de evaluar la producción de biomasa microalgal con alto contenido lipídico, desde su cultivo hasta el análisis de lípidos totales. La biomasa microalgal es la materia orgánica producida a partir del cultivo de microalgas que, bajo determinadas condiciones, acumula los denominados compuestos bioactivos, metabolitos secundarios o biomoléculas. El desarrollo de nuevas técnicas o la modificación de estas, para describir procesos, conllevan a la obtención o mejora de un producto, el cual deberá contar con los máximos niveles de calidad y cantidad que se requiere producir. Durante la investigación, el desarrollo de cada flujo de trabajo, se ha llevado a cabo bajo determinadas condiciones ambientales y estructurales, que deben de servir al usuario como referente mas no como patrón, pues éstas contribuyen, en gran medida, a definir el proceso, que para cada lugar y condición es particularmente especial.

Efeitos de polímeros hidrorretentores nas propriedades físico-hídricas de dois meios porosos

Com o propósito de avaliar os efeitos de polímeros hidrorretentores nas propriedades físicas e hidráulicas de dois meios porosos, realizou-se um experimento no Laboratório de Física do Solo da Universidade Federal do Paraná, entre 18/03 e 30/10/97. O polímero hidrorretentor usado foi produzido na Bélgica e os meios porosos foram um Latossolo Vermelho textura argilosa e uma Areia Quartzosa Marinha, ambos na forma de TFSA. Os polímeros foram aplicados na forma de grãos passados em peneira de 0,5 e 1 mm de diâmetro, nas seguintes concentrações: 0, 2, 4, 8, 16 e 32 kg m-3. Foram elaboradas as curvas de retenção a baixas tensões (0; 0,025; 0,045; 0,10; 0,20; 0,60; 1,5 e 3,0 mH2O), medidas as condutividades hidráulicas saturadas e estimados os diâmetros médios de poros. O processo da evaporação de água do solo foi simulado por modelagem numérica. As curvas de retenção de água medidas e os perfis de umidade simulados da evaporação afastaram-se consideravelmente da origem (testemunhas) pela adição de polímeros, particularmente na Areia Quartzosa Marinha. O diâmetro médio de poros também aumentou progressivamente com o aumento da concentração de polímeros. Foi verificado que, nas concentrações de polímeros acima de 8 kg m-3, as propriedades físico-hídricas dos meios porosos foram dominadas pela ação dos polímeros hidrorretentores.

Erosão hídrica em cambissolo húmico alumínico submetido a diferentes sistemas de preparo e cultivo do solo: II. perdas de nutrientes e carbono orgânico

A erosão hídrica é uma das principais causas do empobrecimento dos solos, por causa do transporte de nutrientes. Os nutrientes são transportados pela erosão hídrica adsorvidos aos colóides do solo e, ou, solubilizados, podendo variar com o sistema de preparo do solo. Este trabalho foi desenvolvido no Campus do Centro de Ciências Agroveterinárias de Lages (SC), no período de janeiro de 1993 a outubro de 1998, com o objetivo de quantificar as perdas por erosão de fósforo, potássio, cálcio, magnésio e carbono orgânico sob chuva natural, nos seguintes sistemas de preparo: (a) aração + duas gradagens, (b) escarificação + gradagem e (c) semeadura direta executados no sentido paralelo ao declive, com rotação e sucessão de culturas nos três sistemas. Na rotação, foi utilizada a seguinte seqüência de culturas: soja, aveia preta, feijão, ervilhaca comum, milho, ervilhaca comum, soja, trigo, feijão, nabo forrageiro, milho e aveia preta e, na sucessão, trigo e soja em todos os anos. Outro tratamento constou de (d) aração + duas gradagens + solo sem cultura, preparado no sentido paralelo ao declive. Utilizou-se um Cambissolo Húmico alumínico argiloso, com 0,102 m m-1 de declividade média. A concentração de fósforo, potássio, cálcio, magnésio e carbono orgânico no solo foi, em geral, maior nos preparos conservacionistas do que nos convencionais. No entanto, a perda total dos referidos elementos foi, em geral, pouco influenciada pelos sistemas de preparo do solo, relacionando-se fracamente com as perdas de solo e água. As concentrações desses nutrientes no sedimento da erosão correlacionaram-se positivamente com as suas concentrações na camada de 0-0,025 m de profundidade do solo, apresentando uma taxa de enriquecimento próximo a um.

Bortezomib(Velcade (R))-Thalidomide-Dexamethasone (VTD) Is Superior to Thalidomide-Dexamethasone (TD) In Patients with Multiple Myeloma (MM) Progressing or Relapsing After Autologous Transplantation.

Introduction: The Thalidomide-Dexamethasone (TD) regimen has provided encouraging results in relapsed MM. To improve results, bortezomib (Velcade) has been added to the combination in previous phase II studies, the so called VTD regimen. In January 2006, the European Group for Blood and Marrow Transplantation (EBMT) and the Intergroupe Francophone du Myélome (IFM) initiated a prospective, randomized, parallel-group, open-label phase III, multicenter study, comparing VTD (arm A) with TD (arm B) for MM patients progressing or relapsing after autologous transplantation. Patients and Methods: Inclusion criteria: patients in first progression or relapse after at least one autologous transplantation, including those who had received bortezomib or thalidomide before transplant. Exclusion criteria: subjects with neuropathy above grade 1 or non secretory MM. Primary study end point was time to progression (TTP). Secondary end points included safety, response rate, progression-free survival (PFS) and overall survival (OS). Treatment was scheduled as follows: bortezomib 1.3 mg/m2 was given as an i.v bolus on Days 1, 4, 8 and 11 followed by a 10-Day rest period (days 12 to 21) for 8 cycles (6 months) and then on Days 1, 8, 15, 22 followed by a 20-Day rest period (days 23 to 42) for 4 cycles (6 months). In both arms, thalidomide was scheduled at 200 mg/Day orally for one year and dexamethasone 40 mg/Day orally four days every three weeks for one year. Patients reaching remission could proceed to a new stem cell harvest. However, transplantation, either autologous or allogeneic, could only be performed in patients who completed the planned one year treatment period. Response was assessed by EBMT criteria, with additional category of near complete remission (nCR). Adverse events were graded by the NCI-CTCAE, Version 3.0.The trial was based on a group sequential design, with 4 planned interim analyses and one final analysis that allowed stopping for efficacy as well as futility. The overall alpha and power were set equal to 0.025 and 0.90 respectively. The test for decision making was based on the comparison in terms of the ratio of the cause-specific hazards of relapse/progression, estimated in a Cox model stratified on the number of previous autologous transplantations. Relapse/progression cumulative incidence was estimated using the proper nonparametric estimator, the comparison was done by the Gray test. PFS and OS probabilities were estimated by the Kaplan-Meier curves, the comparison was performed by the Log-Rank test. An interim safety analysis was performed when the first hundred patients had been included. The safety committee recommended to continue the trial. Results: As of 1st July 2010, 269 patients had been enrolled in the study, 139 in France (IFM 2005-04 study), 21 in Italy, 38 in Germany, 19 in Switzerland (a SAKK study), 23 in Belgium, 8 in Austria, 8 in the Czech republic, 11 in Hungary, 1 in the UK and 1 in Israel. One hundred and sixty nine patients were males and 100 females; the median age was 61 yrs (range 29-76). One hundred and thirty six patients were randomized to receive VTD and 133 to receive TD. The current analysis is based on 246 patients (124 in arm A, 122 in arm B) included in the second interim analysis, carried out when 134 events were observed. Following this analysis, the trial was stopped because of significant superiority of VTD over TD. The remaining patients were too premature to contribute to the analysis. The number of previous autologous transplants was one in 63 vs 60 and two or more in 61 vs 62 patients in arm A vs B respectively. The median follow-up was 25 months. The median TTP was 20 months vs 15 months respectively in arm A and B, with cumulative incidence of relapse/progression at 2 years equal to 52% (95% CI: 42%-64%) vs 70% (95% CI: 61%-81%) (p=0.0004, Gray test). The same superiority of arm A was also observed when stratifying on the number of previous autologous transplantations. At 2 years, PFS was 39% (95% CI: 30%-51%) vs 23% (95% CI: 16%-34%) (A vs B, p=0.0006, Log-Rank test). OS in the first two years was comparable in the two groups. Conclusion: VTD resulted in significantly longer TTP and PFS in patients relapsing after ASCT. Analysis of response and safety data are on going and results will be presented at the meeting. Protocol EU-DRACT number: 2005-001628-35.

How to screen for problematic cannabis use in population surveys: an evaluation of the Cannabis Use Disorders Identification Test (CUDIT) in a Swiss sample of adolescents and young adults.

BACKGROUND/AIMS: Cannabis use is a growing challenge for public health, calling for adequate instruments to identify problematic consumption patterns. The Cannabis Use Disorders Identification Test (CUDIT) is a 10-item questionnaire used for screening cannabis abuse and dependency. The present study evaluated that screening instrument. METHODS: In a representative population sample of 5,025 Swiss adolescents and young adults, 593 current cannabis users replied to the CUDIT. Internal consistency was examined by means of Cronbach's alpha and confirmatory factor analysis. In addition, the CUDIT was compared to accepted concepts of problematic cannabis use (e.g. using cannabis and driving). ROC analyses were used to test the CUDIT's discriminative ability and to determine an appropriate cut-off. RESULTS: Two items ('injuries' and 'hours being stoned') had loadings below 0.5 on the unidimensional construct and correlated lower than 0.4 with the total CUDIT score. All concepts of problematic cannabis use were related to CUDIT scores. An ideal cut-off between six and eight points was found. CONCLUSIONS: Although the CUDIT seems to be a promising instrument to identify problematic cannabis use, there is a need to revise some of its items.

Strategies for improving outcomes in NSCLC: a look to the future.

Advances in the management of non-small cell lung cancer (NSCLC) over the past 30 years have led to small increases in 5-year survival rates across Europe, though further improvements may require new treatment strategies. In order to improve efficiency and reduce the cost of development, future trials for new targeted agents in NSCLC should aim to recruit patients on the basis of tumour biology rather than clinical characteristics. However, identification of predictive biomarkers is required to maximise the benefits of new approaches and expedite the drug development process. Nevertheless, the NSCLC landscape is changing rapidly, and recent improvements in our understanding of the molecular biology of the disease will help in the identification of novel targeted agents as well as assisting in the development of personalised strategies for the numerous small subsets of defined NSCLC. Progress in imaging and treatment delivery is also likely to improve outcomes for patients with the disease. This article outlines recent progress in the treatment of NSCLC, identifies current challenges and describes proposals for improving the future management of the disease. It is hoped that implementation of some of these strategies will go some way to improving the outlook for patients with NSCLC.

L'agression de la victime, une modalité de gestion de la conflictualité psychique et de restauration d'une continuité interne

Cet article interroge les fonctions psychologiques que peuvent occuper les victimes dans l'économie psychique de l'auteur d'une agression, dans le cadre de la commission de certaines infractions à caractère sexuel et violent. Nous montrerons que chez des sujets pour lesquels la dynamique psychique de l'acte renvoie à un mouvement défensif contre des angoisses majeures sur le plan identitaire et objectal, le recours à la victime dans l'acte d'agression assurerait une fonction de continuité interne face à la discontinuité identitaire.

Erosão hídrica em um Nitossolo Háplico submetido a diferentes sistemas de manejo sob chuva simulada. II - Perdas de nutrientes e carbono orgânico

Com a erosão hídrica, há o transporte de nutrientes para fora das lavouras e, com isso, pode ocorrer o empobrecimento dos solos e a contaminação do ambiente fora do local da erosão. Utilizando um simulador de chuvas de braços rotativos, foram aplicadas, no campo, três chuvas simuladas no cultivo do milho e três no de feijão, com intensidade constante de 64 mm h-1 e energia cinética de 0,2083 MJ ha-1 mm-1 , no Planalto Sul Catarinense, entre março de 2001 e abril de 2003, para avaliar as perdas de nutrientes e carbono orgânico (CO) pela erosão hídrica sobre os seguintes tratamentos de manejo do solo, em duas repetições: solo sem cultivo com uma aração + duas gradagens (SSC); cultivos de milho e feijão com uma aração + duas gradagens sobre resíduos dessecados (PCO); cultivos de milho e feijão em semeadura direta sobre resíduos dessecados em solo previamente preparado (SDI); cultivos de milho e feijão em semeadura direta sobre resíduos dessecados em solo nunca preparado (SDD), cultivos de milho e feijão em semeadura direta sobre resíduos queimados em solo nunca preparado (SDQ); e solo sem cultivo com campo nativo melhorado (CNM). Utilizou-se um Nitossolo Háplico alumínico argiloso, com inclinação média do terreno de 0,165 m m-1. As concentrações dos nutrientes e do CO nos sedimentos transportados por erosão foram maiores nos preparos conservacionistas do que nos convencionais, enquanto as perdas totais comportaram-se de maneira inversa. Na água da enxurrada, as concentrações e as perdas de NH4+ e NO3- diminuíram do cultivo do milho para o do feijão, enquanto as de P aumentaram. No caso do K, ocorreu redução da concentração e aumento das perdas. As taxas de empobrecimento do solo situaram-se, em geral, próximas de um para os nutrientes e para o CO. As concentrações dos nutrientes e do CO nos sedimentos transportados correlacionaram-se, linear e positivamente, com a composição química da camada de 0-0,025 m de profundidade do solo de onde o sedimento foi removido.

Variação na temperatura do solo em três sistemas de manejo na cultura do feijão

A temperatura do solo é uma propriedade que afeta diretamente o crescimento das plantas e é influenciada pelo balanço de energia na superfície do solo. Dessa maneira, os sistemas de manejo do solo têm efeito na temperatura, visto que alteram as condições da superfície do solo. O objetivo deste estudo foi determinar o efeito de três sistemas de manejo na temperatura do solo durante todo o ciclo do feijoeiro. O delineamento experimental foi de blocos ao acaso, com os seguintes preparos do solo: plantio direto há sete anos (PD); plantio direto revolvido por uma aração e uma gradagem (PDar) e plantio direto revolvido por escarificador (PDesc), distribuídos em quatro blocos. O solo do experimento é classificado como Argissolo Vermelho-Amarelo distrófico arênico. A temperatura do solo foi determinada durante todo o ciclo do feijoeiro, realizando-se leituras a cada 10 min, em um sistema automatizado de coleta de dados, com sensores do tipo termopar (cobre-constantan), instalados na profundidade de 0,025 m e a 0,10 m. Foram determinadas a densidade do solo e a produtividade do feijoeiro. Durante todo o ciclo do feijoeiro, o PD apresentou a menor temperatura máxima e a menor amplitude diária entre os sistemas de manejo. Na profundidade de 0,025 m, o PDar apresentou temperatura máxima de 42,2 °C, o PDesc de 43,7 °C e o PD de 36,1 °C. A variação diária da temperatura do solo num dia com 12 h de sol, no início do desenvolvimento das plantas (02/12/2002), indicou que a maior temperatura ocorreu próximo às 15 h, com valores de 40 ºC, no PDar, e 30 ºC, no PD, na profundidade de 0,025 m. Quando as plantas sombreavam o solo, não houve diferenças na temperatura do solo entre os sistemas de manejo. As diferenças na temperatura do solo não provocaram diferenças na produtividade de grãos do feijoeiro, haja vista que os maiores efeitos da temperatura do solo ocorrem na germinação e emergência das plântulas.

Carga máxima de fósforo admissível ao reservatório Piraquara II, uma aplicação do processo TMDL

Para implementação e operacionalização da política brasileira de recursos hídricos, é imprescindível o uso de ferramentas de planejamento que considerem o efeito de todas as atividades ou processos que causam ou contribuem para a degradação da qualidade de um corpo d'água. Neste sentido, aplicou-se o processo TMDL (total maximum daily load), desenvolvido pela Agência de Proteção Ambiental dos Estados Unidos (EPA), para o P, na área de drenagem de contribuição ao futuro reservatório Piraquara II, bacia hidrográfica do rio Piraquara, Paraná. O processo TMDL determina a quantidade máxima de cargas de um poluente que um corpo d'água pode receber sem violar os padrões estabelecidos de qualidade da água e aloca cargas deste poluente entre fontes de poluição pontuais e difusas. No presente estudo, utilizou-se o método TMDL, com o objetivo de demonstrar ser ele uma ferramenta útil no processo de gestão dos recursos hídricos. Simularam-se cenários de uso do solo, por meio de modelagem matemática, até obter-se uma concentração de P total no reservatório abaixo da faixa limite para ocorrência de eutrofização, de 0,025 a 0,10 mg L-1, estabelecida no estudo. Realizou-se uma simulação de uso atual do solo, visando prever a condição inicial de qualidade da água no corpo d'água, na qual a concentração de P total no reservatório resultante não atendeu ao padrão estabelecido. Procedeu-se a uma segunda simulação com adoção das medidas de controle, recomposição de mata ciliar e plantio direto, para reduzir a exportação de carga de P total da bacia. Obteve-se uma melhoria na qualidade da água do reservatório, indicando que as medidas adotadas foram suficientes para atingir o padrão estabelecido, o que demonstra a aplicabilidade do método.