O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Ocorrência de bactérias do gênero Aeromonas em queijo-de-minas frescal artesanal

Foram analisadas 160 amostras de queijo-de-minas frescal artesanal, adquiridas no comércio varejista dos municípios de Poços de Caldas - MG e Jaboticabal - SP, a fim de verificar a ocorrência de bactérias do gênero Aeromonas no produto. Oitenta e duas (51,2%) encontravam-se contaminadas pelos microrganismos, com populações que variavam de 5,0×10³ a 4,0×10(5) UFC/grama. Foram identificadas as espécies Aeromonas hydrophila, Aeromonas caviae, Aeromonas schubertii, além de cepas consideradas atípicas. Os resultados evidenciam que bactérias do gênero Aeromonas podem ser veiculadas através do queijo tipo minas frescal artesanal e devem servir de alerta aos serviços de saúde pública.

Complicações das vias aéreas relacionadas à intubação endotraqueal

Descrevemos as principais complicações das vias aéreas relacionadas à intubação endotraqueal, por meio de revisão da literatura e apresentação dos resultados de pesquisas clínicas e experimentais realizadas pelo nosso grupo de estudo. Procuramos alertar os profissionais de saúde quanto à alta incidência de complicações secundárias à intubação, as quais podem ser reduzidas com a adoção de medidas profiláticas simples e de cunho prático, estabelecidas após a compreensão da fisiopatologia das lesões.

Mineração subterrânea de carvão X comunidade no seu entorno: um exemplo de Santa Catarina

Historicamente a convivência entre a mineração e a população sempre foi problemática, com prejuízos enormes para esta última, que, por problemas da falta de moradia, tem de conviver com a degradação do meio ambiente ao seu redor, como a poluição através da poeira, ruído e vibração. Esse trabalho, com dados coletados na mina subterrânea de carvão Trevo, na região carbonífera de Santa Catarina, coloca em evidência a necessidade da integração Empresa x Comunidade, no sentido da melhoria das técnicas de mineração e do meio ambiente, visando a uma convivência pacífica e tendo como um dos seus principais resultados alertar e despertar a consciência da Empresa ante aos reclamos da comunidade, demonstrando-se com dados, o perigo decorrente do planejamento de uma lavra sem levar em conta as habitações em superfície.

Mutagenic activity in waste from an aluminum products factory in Salmonella/microsome assay

The mutagenic activity of waste material originating from an aluminum products factory was determined by the Salmonella/microsome assay, using the bacterial strains TA100, TA98 and YG1024. The material was obtained by sweeping the factory floor at the end of the work shift. Organic compounds were extracted by ultrasound for 30 min in dichloromethane or 70% ethanol. After evaporation of solvent, these extracts were dissolved in dimethylsulfoxide, and tested for the mutagenic activity at varying concentrations. All the extracts from the factory had mutagenic activity, especially in the YG1024 strain, suggesting the presence of aromatic amines, later confirmed by chemical analysis. The TA98 strain also showed mutagenic activity, though it did not exhibit the highest mutagenicity index observed with the YG1024 strain. In TA100, mutagenic activity was not observed. This study should serve as an alert to management and those who are occupationally exposed, and as a warning that this type of waste should not be discarded in the environment without any control. (C) 2004 Elsevier Ltd. All rights reserved.

Mosca-Negra-dos-Citros: Características Gerais, Bioecologia e Métodos de Controle dessa Importante Praga Quarentenária da Citricultura Brasileira

Citrus blackfly, Aleurocanthus woglumi Ashby, is a serious pest of citrus culture and other economically important fruit crops. It is a present quarantine pest or A2 maximum alert restricting trades with other regions free of its presence. Since the frst occurrence of the citrus blackfly in Belem in 2001 its dissemination was quickly to other States and regions of citrus production in Brazil. As an exotic pest, basic knowledge is scarce in order to establish the appropriate management to the insect in Brazil. Thus, the aim of the present study was to provide information about important aspects of A. woglumi, such as: history and geographical distribution, bioecology, host plants, appropriate control methods, among others, in order to provide subsidies for futures researches about the citrus blackfly in Brazil.

Manifestações otorrinolaringológicas em crianças com AIDS

Introduction: The study of otolaryngologic manifestations in children HIV + can lead to early diagnosis of AIDS, allowing specific treatment, responsible by reduced morbidity and mortality. Objectives: Detect the otolaryngologic manifestations in children with AIDS and alert to the importance of the early diagnosis. Study design: Clinical prospective. Material and method: We evaluated 22 children with AIDS assisted at Faculdade de Medicina de Botucatu (São Paulo, Brasil). The medical records were reviewed and the children were submitted to otolaryngologic and hearing acuity exams. Results: We evaluated 12 boys and 10 girls, whose ages ranged from 8 months to 12 years. In B and C clinical classification were included 18 children who were using anti-retroviral medicaments. Physical examination mainly indicated cervical lymphadenopathy (18 cases), paleness of the nasal mucous membrane with abundant mucous secretion over the nasal epithelium (15 cases) and retraction of tympanic membranes (seven cases). The main otolaryngologic diagnoses were: rhinosinusitis (16 cases), oral candidiasis (13 cases), inadequate eustachian tube function (seven cases) and recurrent tonsillar infections (six cases). Conductive hearing loss were detected in 4 children. No child presented sensorineural hearing loss. Conclusions: The main otolaryngologic manifestations presented by the children with HIV virus were rhinosinusitis, oral candidiasis, inadequate eustachian tube function and recurrent tonsillar infections. The allergic aspect of the nasal mucous membrane and the cervical lymphadenopathy were frequent signs and could alert the otolaryngologyst to AIDS during the exam.

Surface roughness of packable composite resins polished with various systems

Purpose: The aim of this study was to evaluate the surface roughness of four packable composite resins, SureFil™ (Dentsply, Petrópolis, Rio de Janeiro, Brazil), Prodigy Condensable™ (Kerr Co., Orange, CA, USA), Filtek P60™ (3M do Brasil, São Paulo, Brazil), and ALERT® (Jeneric/Pentron, Inc., Wallingford, CT, USA) and one microhybrid composite resin (Filtek Z250™, 3M do Brasil) after polishing with four finishing systems. Materials and Methods: Twenty specimens were made of each material (5 mm in diameter and 4 mm high) and were analyzed with a profilometer (Perthometer® S8P, Perthen, Mahr, Germany) to measure the mean surface roughness (Ra). The specimens were then divided into four groups according to the polishing system: group 1 - Sof-Lex™ (3M do Brasil), group 2 - Enhance™ (Dentsply), group 3 - Composite Finishing Kit (KG Sorensen, Barueri, São Paulo, Brazil), and group 4 - Jiffy Polisher Cups® (Ultradent Products, Inc., South Jordan, UT, USA). The specimens were polished and then evaluated for Ra, and the data were subjected to analysis of variance, analysis of covariance, and Tukey's test (p = .05). Results: The mean Ra of SureFil polished with Sof-Lex was significantly lower than that of KG points. Prodigy Condensable polished with Enhance showed a significantly less rough surface than when polished with Sof-Lex. Filtek P60 did not exhibit a significant difference with the various polishing systems. For ALERT the lowest mean Ra was obtained with Sof-Lex and the highest mean Ra with KG points. Regarding Filtek Z250, polishing with KG and Jiffy points resulted in a significantly lower mean Ra than when polished with Enhance. Conclusions: Packable composite resins display variable roughness depending on the polishing system used; the Sof-Lex disks and Jiffy points resulted in the best Ra values for the majority of the materials tested.

Uma leitura de 26 poetas hoje

This reading presents a sample from this anthology and tries to identify in it the faces of resistence indicated by Alfredo Bosi in his essay: Poesia Resistência. ln the several manners the poets of different generations chose for their personal cry of alert we find a poetry wich is spontaneous, authentic and, above all, resistent. This is due mainly to the renewal of the poetical expression, impregnated with affectiveness and intimism, which included colloquial language and the devices used by all great Brazilian poetry since the Modernism of 1922.

Ventilatory frequency of Nile tilapia subjected to different stressors

Ventilatory frequency (VF) was investigated in the fish Nile tilapia, Oreochromis niloticus, subjected to confinement, electroshock or social stressor. Fish were allowed to acclimatize to tank conditions for 10 days (1 fish/aquarium). VF baseline was determined 5 days after adjustment had been started. At the 10th day of isolation, stressor effects on VF were assessed. The stressors were imposed during 60 min: pairing with a larger resident animal (social stressor), or gentle electroshock (AC, 20 V, 15 mA, 100 Hz for 1 min every 4 min), or space restriction (confinement). VF was quantified immediately after the end of the stressor imposition. Baseline of VF was not statistically different among groups. Social stressor clearly induced VF to increase, while an increased or decreased VF can be observed for both confinement and electroshock. However, fish tend to increase their VF in response to confinement and decrease in the case of electroshock. These results suggest that VF is a sensitive behavioural indicator for distinguishing stress responses in the fish Nile tilapia among different stressors. © 2006 Elsevier GmbH. All rights reserved.

In vitro evaluation of surface roughness of 4 resin composites after the toothbrushing process and methods to recover superficial smoothness.

OBJECTIVE: This study evaluated the efficiency of repolishing, sealing with surface sealant, and the joining of both in decreasing the surface roughness of resin-based composites after a toothbrushing process. METHOD AND MATERIALS: Ten specimens of each composite (Alert, Z100, Definite, and Prodigy Condensable), measuring 2 mm in thickness and 4 mm in diameter, were made and submitted to finishing and polishing processes on both sides of the specimens using the Sof-Lex system. The specimens were then subjected to toothbrushing (30,000 cycles), and surface roughness (Ra) was analyzed with a Surfcorder SE 1700 profilometer. The upper surface of each composite was etched with 37% phosphoric acid, and the surface-penetrating sealant Protect-it was applied on 1 surface. The roughness of these surfaces was again measured. On the other side, the surface of the specimen was repolished, and the efficiency of this procedure was measured using the profilometer. The surface roughness resulting from the joining of the 2 methods was verified by applying, in the final stage, the surface-penetrating sealant on the repolished surface. Data were analyzed with analysis of variance and Tukey test (P <.05). RESULTS: Results showed that the lowest surface roughness values were obtained for Definite, Z100, and Prodigy Condensable after the repolishing process and after the repolishing plus sealing. For Alert, the joining of repolishing plus sealing promoted the lowest values of surface roughness. CONCLUSION: Of the resin-based composites, Alert demonstrated the highest values of surface roughness in all the techniques tested.

Preliminary Overview of the Economies of Latin America and the Caribbean 2006

Includes bibliography

Incidência e evolução da polipose nasal em crianças e adolescentes com fibrose cística

Nasal polyps are a clinical sign of alert for investigating Cystic Fibrosis (CF). Aims: To study the incidence of nasal polyps in children and adolescents with cystic fibrosis, its possible association with age, gender, clinical manifestations, genotype and sweat chlorine level, and its evolution with topical steroid therapy. Methods: Clinical symptoms, sweat chlorine level and genotype were studied in 23 cystic fibrosis patients. Nasal polyps were diagnosed by nasal endoscopy and treated with topical steroids during 6 months, followed by a second nasal endoscopy. Fisher test was used for statistical analysis. Results: Nasal polyps were found in 39.1% of the patients (five bilateral, four unilateral), all older than six years, recurrent pneumonia in 82.6%, pancreatic insufficiency in 87% and malnutrition in 74%. No association was seen between nasal polyps and sweat chlorine level, genotype, clinical sings of severity and nasal symptoms. Seven patients improved in their nasal polyps with topical steroids, six showed complete resolution. Conclusion: The study showed a high incidence of nasal polyps in older children, who span the entire range of clinical severity, even in the absence of clinical nasal symptoms. Topical steroid therapy showed good results. An interaction among pediatricians and otolaryngologists is necessary for diagnosis and follow-up. 2008 © Revista Brasileira de Otorrinolaringologia. All Rights reserved.

Population and health in Latin America and the Caribbean: outstanding matters, new challenges

Spanish version available at the Library

Genetic and modifying factors that determine the risk of brain tumors

Some modifying factors may determine the risk of brain tumors. Until now, it could not be attempted to identify people at risk and also to improve significantly disease progression. Current therapy consists of surgical resection, followed by radiation therapy and chemotherapy. Despite of these treatments, the prognosis for patients is poor. In this review, we highlight general aspects concerning genetic alterations in brain tumors, namely astrocytomas, glioblastomas, oligodendrogliomas, medulloblastomas and ependymomas. The influence of these genetic alterations in patients' prognosis is discussed. Mutagen sensivity is associated with cancer risk. The convincing studies that linked DNA damages and DNA repair alterations with brain tumors are also described. Another important modifying factor is immunity. General immune response against cancer, tumor microenvironment and immune response, mechanisms of tumor escape, CNS tumor immunology, immune defects that impair anti-tumor systemic immunity in brain tumor patients and local immunosuppressive factors within CNS are also reviewed. New hope to treatment perspectives, as dendritic-cell-based vaccines is summarized too. Concluding, it seems well established that there is association between brain tumor risk and mutagen sensivity, which is highly heritable. Primary brain tumors cause depression in systemic host immunity; local immunosuppressive factors and immunological characteristics of tumor cells may explain the poor prognosis and DNA damages responses can alert immune system. However, it is necessary to clarify if individuals with both constitutional defects in immune functions and genetic instability have higher risk of developing brain tumors. Cytogenetic prospective studies and gene copy number variations analysis also must be performed in peripheral lymphocytes from brain tumor patients. © 2011 Bentham Science Publishers Ltd.