Ureteroscopy in Pregnant Women for Ureteral Stone

Introduction: The occurrence of urolithiasis in pregnancy represents a challenge in both diagnosis and treatment of this condition, because it presents risks not only to the mother but also to the fetus. Surgical treatment may be indicated for patients with infection, persistent pain, and obstruction of a solitary kidney. We present our experience on the management of pregnant patients with ureteral calculi and a review of the literature.Materials and Methods: The charts of 19 pregnant patients with obstructive ureteral calculi were retrospectively reviewed. Gestational age ranged from 13 to 33 weeks. In all patients, ureteral stone was diagnosed on abdominal ultrasound. In regard to localization, 15 calculi were in the distal ureter, 3 in the proximal ureter, and 1 in the interior of an ureterocele. Calculi size ranged from 6 to 10 mm (mean, 8 mm). The following criteria were used to indicate ureteroscopy: persistent pain with no improvement after clinical treatment, increase in renal dilation, or presence of uterine contractions. Nine patients (47.3%) were submitted to ureteroscopy. All calculi (100%) were removed with a stone basket extractor under continuous endoscopic vision. None of the calculi demanded the use of a lithotriptor.Results: Nine patients (47.3%) treated with clinical measurements presented no obstetric complications and spontaneous elimination of the calculi. Nine patients (47.3%) submitted to ureteroscopy had no surgical complications. There was remission of pain in all cases after ureteroscopy and ureteral catheter placement.Conclusion: The diagnosis and treatment of ureteral lithiasis in pregnant women present potential risks for the fetus and the mother. Conservative management is the first option, but ureteroscopy may be performed with safety and high success rates.

Relação entre o índice de massa corporal e a gravidade da asma em adultos

OBJETIVO: O aumento do índice de massa corporal (IMC) tem sido associado a uma maior prevalência da asma em adultos. O presente estudo tem o objetivo de avaliar a associação entre a prevalência da obesidade e a gravidade da asma. MÉTODOS: Prontuários de duzentos asmáticos acima dos 20 anos de idade foram avaliados retrospectivamente. A asma foi classificada quanto à gravidade através da história clínica e do diagnóstico registrados, dos resultados da espirometria e da medicação prescrita. O IMC foi calculado e foram considerados obesos os pacientes com IMC > 30 kg/m². RESULTADOS: 23% dos pacientes apresentavam asma intermitente, 25,5%, asma persistente leve, 24%, asma persistente moderada e 27,5%, asma persistente grave. O IMC < 29,9 kg/m² foi observado em 68% dos pacientes e em 32% o IMC foi > 30 kg/m². O odds ratio da relação entre a obesidade e a gravidade da asma foi de 1,17 (CI95%: 0,90-1,53; p > 0,05). CONCLUSÕES: Na amostra estudada não foi encontrada correlação entre a obesidade e a gravidade da asma nem no sexo masculino, nem no feminino.

Molecular detection of Paracoccidioides brasiliensis in road-killed wild animals

Paracoccidioides brasiliensis infections have been little studied in wild and/or domestic animals, which may represent an important indicator of the presence of the pathogen in nature. Road-killed wild animals have been used for surveillance of vectors of zoonotic pathogens and may offer new opportunities for eco-epidemiological studies of paracoccidiodomycosis (PCM). The presence of P. brasiliensis infection was evaluated by Nested-PCR in tissue samples collected from 19 road-killed animals; 3 Cavia aperea (guinea pig), 5 Cerdocyon thous (crab-eating-fox), 1 Dasypus novemcinctus (nine-banded armadillo), 1 Dasypus septemcinctus (seven-banded armadillo), 2 Didelphis albiventris (white-eared opossum), 1 Eira barbara (tayra), 2 Gallictis vittata (grison), 2 Procyon cancrivorus (raccoon) and 2 Sphiggurus spinosus (porcupine). Specific P. brasiliensis amplicons were detected in (a) several organs of the two armadillos and one guinea pig, (b) the lung and liver of the porcupine, and (c) the lungs of raccoons and grisons. P. brasiliensis infection in wild animals from endemic areas might be more common than initially postulated. Molecular techniques can be used for detecting new hosts and mapping 'hot spot' areas of PCM.

Evolutionary dynamics of heterochromatin in the genome of Dichotomius beetles based on chromosomal analysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos tardios dos praguicidas organoclorados no homem

Procurou-se relacionar as informações disponíveis sobre os organoclorados e os efeitos crônicos provocados pela exposição. Os compostos organoclorados são os praguicidas mais persistentes já fabricados. Embora sejam geralmente eficientes no controle das pragas, são importantes poluentes ambientais e potenciais causas de problemas de saúde para o homem, tendo sido proibidos ou controlados na maioria dos países. Com poucas exceções, os efeitos tardios desses compostos sobre a saúde humana são difíceis de detectar, em função de dificuldades metodológicas e da extrapolação dos resultados. A genotoxicidade está entre os mais sérios dos possíveis danos causados por esses compostos e merece atenção especial, devido à natureza irreversível do processo. Outro ponto a ser considerado é o aumento na incidência de alterações no desenvolvimento do trato reprodutivo e na fertilidade masculina observada nas últimas décadas provavelmente decorrente do aumento da exposição intra-uterina a compostos estrogênicos e anti-androgênicos, como os organoclorados.

REDUCTION OF URINE VOLUME AMELIORATES ADRIAMYCIN-INDUCED NEPHROPATHY

1. Adriamycin, a commonly used antineoplastic antibiotic, induces glomerular lesions in rats, resulting in persistent proteinuria and glomerulosclerosis.2. The effect of urine volume on the progression of adriamycin-induced nephropathy was studied in 70 male Wistar rats (180-200 g) observed for 30 weeks and separated into 4 groups: healthy control group (HCG, N = 10) inoculated iv with 1 ml of saline, and nephrotic groups inoculated iv with a single dose of adriamycin of 3 mg/kg body weight. The nephrotic rats were separated into 3 groups (N = 20): nephrotic control group (NCG) receiving only adriamycin; dehydrated nephrotic group (DNG) water deprived for 36 h within each 48-h period, and furosemide nephrotic group (FNG) treated with 12 mg/dl furosemide, and 0.9 g/dl NaCl in the drinking water.3. The 30-week survival rates of the DNG (100%) and HCG (100%) were significantly higher than those of the NCG (85%) and FNG (55%).4. The proteinuria observed in the HCG (range, 7.38 +/- 0.7 to 13.6 +/- 1.27 mg/24 h) was significantly lower than that observed for all the nephrotic groups throughout the experiment. The DNG presented significantly less proteinuria (range, 42.71 +/- 6.83 to 140.10 +/- 19.22 mg/24 h) than the NCG (range, 35.32 +/- 7.64 to 250.00 +/- 25.91 mg/24 h) from week 10 on. There was no significant difference between the mean 24-h proteinuria of the NCG (range, 35.32 +/- 7.64 to 250.00 +/- 25.91 mg/24 h) and the FNG (range, 35.82 +/- 7.91 to 221.54 +/- 26.74).5. The mean frequency of damaged glomeruli was 0.3% +/- 0.3 for HCG, 42% +/- 6% for CNG, 40.8% +/- 8% for DNG, and 47% +/- 14% for FNG. The median value of the tubulointerstitial lesion, evaluated by a semiquantitative method, was 0 in HCG, 10 in CNG, 8.5 in DNG and 9.5 in FNG(P<0.05 for all groups compared to HCG).6. The data indicate that reduction of urine volume has a protective effect on adriamycin-induced nephropathy.

Comparative analysis of drilling frequencies in recent brachiopod-mollusk associations from the Southern Brazilian Shelf

Over 14,000 specimens-5,204 brachiopods, 9,137 bivalves, and 178 gastropods-acquired from 30 collecting stations (0 to 45 m depth) in the Ubatuba and Picinguaba bays, southern Brazil, were compared for drilling frequencies. Beveled (countersunk) circular-to-subcircular borings (Oichnus-like drill holes) were found in diverse bivalves but also in the rhynchonelliform brachiopod Bouchardia rosea-a small, semi-infaunal to epifaunal, free-lying species that dominates the brachiopod fauna of the southern Brazilian shelf. Drill holes in bivalve mollusks and brachiopods are comparable in their morphology, average diameter, and diameter range, indicating attacks by a single type of drilling organism. Drill holes in brachiopods were rare (0.4%) and found only at five sampling sites. Drillings in bivalves were over 10 times as frequent as in brachiopods, but the average drilling frequency was still low (5.6%) compared to typical boring frequencies of Cenozoic mollusks. Some common bivalve species, however, were drilled at frequencies up to 50 times higher than those observed for shells of B. rosea from the same samples. Due to scarcity of drilled brachiopods, it is not possible to evaluate if the driller displayed a nonrandom (stereotyped) site, size, or valve preference. Drilled brachiopods may record (1) naticid or muricid predation, (2) predation by other drillers, (3) parasitic drillings, and (4) mistaken or opportunistic attacks. Low drilling frequency in brachiopods is consistent with recent reports on ancient and modern examples. The scarcity of drilling in brachiopods, coupled with much higher drilling frequencies observed in sympatric bivalves, suggests that drilling in brachiopods may have been due to facultative or erroneous attacks. The drilling frequencies observed here for the brachiopod-bivalve assemblages are remarkably similar to those reported for Permian brachiopod-bivalves associations. This report adds to the growing evidence for an intriguing macroecological stasis: multiple meta-analytical surveys of present-day and fossil rhynchonelliform brachiopods conducted in recent years also point to persistent scarcity and low intensity of biotic interactions between brachiopods and drilling organisms throughout their evolutionary history.

Evaluation of systems for timing of fungicide sprays for control of postbloom fruit drop of citrus in Brazil

Postbloom fruit drop (PFD) of citrus, caused by Colletotrichum acutatum, infects petals of citrus flowers and produces orange-brown lesions that induce the abscission of young fruitlets and the retention of calyces. Proper timing of fungicide applications is essential for good disease control. Different systems for timing of fungicide applications for control of PFD in a major citrus-growing region in southern São Paulo state in Brazil were evaluated from 1999 to 2002. The following programs were compared to an unsprayed control using counts of diseased flowers, persistent calyces, or fruit: (i) a phenology-based program currently recommended in Brazil with one application at early and another at peak bloom; (ii) the Florida PFD model; (iii) the postbloom fruit drop-fungicide application decision system (PFD-FAD), a new computer-assisted decision method; and (iv) grower's choice. In 1999, no disease developed, sprays applied with the phenology-based program had no effect, and the Florida PFD model saved two sprays compared with the phenology-based program. In 2000, PFD was moderate and the phenology-based and growers' choice treatments had a significantly lower number of persistent calyces and higher fruit numbers than the control, but no differences were found between those treatments and the PFD model. In 2001, PFD was severe with considerable yield loss. The PFD model, the phenology-based program, and the grower's choice reduced flower blight and the number of persistent calyces, and improved fruit yields with two to three applications, but the PFD-FAD achieved comparable yields with only one spray. In 2002, the disease was mild, with no yield loss, and the Florida PFD model and the PFD-FAD saved one spray compared with the other systems. The PFD model and the PFD-FAD were equally effective for timing fungicide applications to control PFD in Brazil. Scouting of trees is simpler with PFD-FAD; therefore, this system is recommended and should eliminate unnecessary sprays and reduce costs for growers.

Social Panorama of Latin America 2006

Includes bibliography

Análise temporal do uso e ocupação do solo na microbacia hidrográfica do córrego da Fazenda Glória, Município de Taquaritinga, SP

The role of environmental concern is important due to the disorganized land occupation and intense exploitation of natural resources which lead to the degradation and exhaustion of the environment. Remonte sensing techniques allow identifying, recognizing and mapping areas modifiers besides estimating the extension of alterations made by man. Thus, the objective of this study was to map land use and occupation in order to evaluate the development of the Gloria Farm Stream watershed in Taquaritinga, SP, Brazil, from 1983 to 2000. The drainage network and agricultural and natural vegetation areas were identified by stereoscopic analyses of 2000 aerial photographs and by data analyses of the field and cartographic documents. The results verified that sugarcane became predominat in 2000 and it is distributed in relatively large areas with detriment to citrus orchards and other crops. The presence of dams, which is not noted in 1983 data, and the increase of forest and natural vegetal fragment areas in the analyzed period was observed. Recovered areas dur to reforestation with native species were identified along the streams and springs of Jabuticabal Mountain Range.

Cirurgia micrográfica de Mohs

Mohs Micrographic Surgery is regarded as a very useful technique for the excision of difficult to han- dle skin cancers. The procedure is divided into clearly defined steps: tumor evaluation and marking, tumor exeresis, tissue preparation and mapping, histologic processing and analysis, and closing of the surgical wound. The histologic analysis of all surgical margins leads to higher cure rates and tissue conservation, which make the procedure safer and more reliable.

Galileo's surveying potential E5 pseudorange precision

New Galileo signals have great potential for pseudorange-based surveying and mapping in both optimal open-sky conditions and suboptimal under-canopy environments. This article reviews the main features of Galileo's E5 AItBO( and El (BOC signals, describes generation of realistic E5 and El pseudoranges with and without multipath sources, and presents anticipated horizontal positioning accuracy results, ranging from 4 centimeters (open-sky) to 14 centimeters (under-canopy) for E5/El.

Effect of MTA-based sealer on the healing of periapical lesions

Some manufacturers have recently added specific components to improve the ease of handling and insertion material properties of MTA in order to create MTA-based sealers. Objective: The aim of this study was to evaluate the healing of periapical lesions in canine teeth after a single session of endodontic treatment with MTA Fillapex® compared with Sealapex® or Endo-CPM-Sealer®. Material and Methods: Sixty-two root canals were performed on two 1-year-old male dogs. After coronal access and pulp extirpation, the canals were exposed to the oral cavity for 6 months in order to induce periapical lesions. The root canals were prepared, irrigated with a solution of 2.5% sodium hypochlorite and filled with gutta-percha and different sealers, according to the following groups: 1) Sealapex®; 2) Endo-CPM-Sealer®; and 3) MTA Fillapex®. Some teeth with periapical lesions were left untreated for use as positive controls. Healthy teeth were used as negative controls. After 6 months, the animals were sacrificed and serial sections from the roots were prepared for histomorphologic analysis and stained with hematoxylin and eosin and the Brown and Brenn technique. The lesions were scored according to pre-established histomorphologic parameters and the scores statistically analyzed using the Kruskal-Wallis test. Results: All 3 materials produced similar patterns of healing (p>0.05); in particular, persistent inflammation and absence of complete periapical tissue healing were consistently noted. Conclusions: Preparation of the infected root canals followed by filling with the materials studied was insufficient to provide complete healing of the periapical tissues.

Qualidade de vida de crianças e adolescentes asmáticos: Sua relação com estratégias de enfrentamento materno

Objective: To evaluate the quality of life of asthmatic children and adolescents, its relation with sociodemographic and clinical variables, and maternal coping strategies. Methods: Cross-sectional study in which children and adolescents with asthma answered a quality of life questionnaire, and their mothers did the same with a coping scale. Results: Out of the 42 children and adolescents investigated, 74% were classified as having mild/severe persistent asthma; 19%, mild persistent asthma; and 7%, intermittent asthma. A total of 69% of the participants showed impaired quality of life with mean scores ranging between 4.7 and 3.5, with greater harm in the domain of symptoms (score=3.6). There was a significant association between maternal schooling and the general index of quality of life, whereas maternal coping strategies were not associated with the severity of asthma. A large number of strategies used by mothers to cope with their children's crises were related to the management of stressors or to religious practices, and the latter presented negative correlation with the children's quality of life general index, showing that mothers whose children had worse quality of life used more religious coping. Conclusions: Asthmatic children, particularly those with moderate/severe persistent asthma, showed significant alterations as to quality of life. The high percentage of mothers using religious strategies, particularly in face of more severe clinical conditions, seem to indicate that they feel powerless to act, thus requiring concrete and useful orientation to low income families.

Optimal impulsive control in a powered Swing-By

This paper studies the problem of applying an impulsive control in a spacecraft that is performing a Swing-By maneuver. The objective is to study the changes in velocity, energy and angular momentum for this maneuver as a function of the three usual parameters of the standard Swing-By plus the three parameters (the magnitude of the impulse, the point of its application and the angle between the impulse and the velocity of the spacecraft) that specify the impulse applied. The dynamics used is the restricted three body problem under the regularization of Lemaitre, made to increase the accuracy of the numerical integration near the primaries. The present research develops an algorithm to calculate the variation of energy and angular momentum in a maneuver where the application of the impulsive control occurs before or after the passage of the spacecraft by the periapsis, but within the sphere of influence of the secondary body and in a non-tangential direction. Using this approach, it is possible to find the best position and direction to apply the impulse to maximize the energy change of the total maneuver. The results showed that the application of the impulse at the periapsis and in the direction of motion of the spacecraft is usually not the optimal solution.