Day case stapled haemorrhoidopexy for prolapsing haemorrhoids

Objective Conventional surgical management of prolapsing haemorrhoids is by excisional haemorrhoidectomy. Postoperative pain has restricted the application of such procedures in the day case setting. These operations remain associated with a period of restricted activity. The use of circular stapling devices as an alternative to the excisional approach in the management of haemorrhoids has been described. This study reports our experience of stapled haemorrhoidopexy as a day case procedure.

Methods Patients with third or fourth degree haemorrhoids were eligible for the procedure. Patients were considered suitable candidates for day case surgery based on conventional parameters. Symptoms were assessed using a previously validated symptom severity rating score. Stapled haemorrhoiclopexy was carried out using a circular stapling device. Pain scores were obtained prior to discharge. Patients were admitted if pain was uncontrolled despite oral analgesia. Symptoms were re-scored at six-week follow-up.

Results Over a 70-month period 168 consecutive stapled haemorrhoidopexies were performed or directly supervised by one consultant colorectal surgeon. One hundred and ten (65%) patients were considered appropriate candidates for day case surgery by conventional criteria. Ninety-six (87.3%) patients successfully underwent stapled haemorrhoidopexyon a day case basis. Fourteen (12.7%) patients required admission on the day of surgery (5 for early Postoperative bleeding, 4 for pain necessitating continuing opiate analgesia, two for urinary retention and three for surgery performed late in the day). Six (5%) patients were re-admitted postoperatively; four for pain relief and two because of urinary retention. Of the day case patients, 91 (82.7%) and 56 (50.9%) had been seen for 6 week and 6 month review, respectively, at the time of analysis. Symptom scores were 6 (pre-operatively) vs 0 (postoperatively) (P <0.01). 76/91 (83.5%) patients reviewed at 6/52 were asymptomatic.

Conclusion Stapled haemorrhoidopexy is a safe and effective procedure that can be carried out on selected patients on a day case basis. Complications are of a similar nature to excisional haemorrhoidectomy.

Plasma Clusterin Levels and the rs11136000 Genotype in Individuals with Mild Cognitive Impairment and Alzheimer's Disease

Aim: Substantial evidence links atherosclerosis and Alzheimer's disease (AD). Apolipoproteins, such as apolipoprotein E, have a causal relationship with both diseases. The rs11136000 SNP within the CLU gene, which encodes clusterin (apolipoprotein J), is also associated with increased AD risk. The aim of this study was to investigate the relationship between plasma clusterin and the rs11136000 genotype in mild cognitive impairment (MCI) and AD.

Methods: Plasma and DNA samples were collected from control, MCI and AD subjects (n=142, 111, 154, respectively). Plasma clusterin was determined by ELISA and DNA samples were genotyped for rs11136000 by TaqMan assay.

Results: Plasma clusterin levels were higher in MCI and AD subjects vs. controls (222.3 +/- 61.3 and 193.6 +/- 58.2 vs. 178.6 +/- 52.3 mu g/ml, respectively; p

Conclusion: This study examined control, MCI and AD subjects, identifying for the first time that plasma clusterin levels were influenced, not only by the presence of AD, but also the transitional stage of MCI, while rs11136000 genotype only influenced plasma clusterin levels in the control group. The increase in plasma clusterin in MCI and AD subjects may occur in response to the disease process and would be predicted to increase binding capacity for amyloid-beta peptides in plasma, enhancing their removal from the brain.

Post-synthetic modification of metal–organic frameworks

Post-synthetic modification (PSM) of metal-organic frameworks encompassing the chemical transformation of the linker present is a promising new route for engineering optical centres and tuning the light emission properties of materials, both in the visible and in the near infrared (NIR) spectral regions. Here, PSM of isoreticular metal-organic framework-3 (IRMOF-3) with ethyl oxalyl monochloride, ethyl acetoacetate, pentane-2,4-dione, 3-(2- hydroxyphenyl)-3-oxopropanal, 2-chloroacetic acid, glyoxylic acid, methyl vinyl ketone and diethyl (ethoxymethylene)malonate followed by chelation of trivalent lanthanide ions afforded intriguing near infrared (Nd3+) and visible (Eu3+, Tb3+) light emitters. IRMOF-3 was used as a case in point due to both its highly porous crystalline structure and the presence of non-coordinating amino groups on the benzenedicarboxylate (bdc) linker amenable to modification. The materials were characterised by elemental analysis, powder X-ray diffraction, optical, scanning and transmission electron microscopy, Fourier transform infrared spectroscopy, and liquid and solid-state nuclear magnetic resonance. The solid-state luminescence properties of Ln-modified-IRMOF-3 were investigated at room temperature. The presence of the bdc aromatic ring, β– diketonate and oxalate enhanced the Ln3+ sensitization via ligand-to-metal energy transfer (anthena effect). As far as photocalysis is concerned, we have synthesized metal−organic frameworks (Cr-MIL-125-AC, Ag-MIL-125-AC) by a green method (solid–vapors reactions). The resulting functionalized materials show a photocatalytic activity for methylene blue degradation up to 6.52 times larger than that of the commercial photocatalyst hombikat UV-100. These findings open the door for further research for improving the photocatalytic performance of metal-organic frameworks.

Genotipificación de HLA-B en pacientes colombianos afectados por el síndrome Stevens-Johnson y la Necrólisis Epidérmica Tóxica

Las reacciones alérgicas a medicamentos cutáneas severas (RAM) como el Síndrome Stevens Johnson (SJS) y la Necrólisis Epidérmica Tóxica (NET),caracterizadas por exantema, erosión de la piel y las membranas mucosas, flictenas, desprendimiento de la piel secundario a la muerte de queratinocitos y compromiso ocular. Son infrecuentes en la población pero con elevada morbi-mortalidad, se presentan luego de la administración de diferentes fármacos. En Asia se ha asociado el alelo HLA-B*15:02 como marcador genético para SJS. En Colombia no hay datos de la incidencia de estas RAM, ni de la relación con medicamentos específicos o potenciales y tampoco estudios de aproximación genómica de genes de susceptibilidad.

Incidencia y factores asociados a infección en el primer año postrasplante cardiaco

Objetivo: Determinar la incidencia de las infecciones en el primer año postrasplante cardiaco y los factores asociados a las infecciones en este periodo. Materiales y métodos: Estudio analítico de casos y controles anidados en una cohorte, con los pacientes trasplantados cardiacos en la Fundación Cardioinfantil – Instituto de cardiología desde el año 2005 hasta el 2015. Se realizaron análisis univariados, análisis bivariado entre las variables del estudio y el desenlace para la selección de las variables para el modelo de regresión logística. Resultados: Se presentó una mediana de 54 años de edad en la cohorte, con mayor proporción de hombres (75,8%) y con predominio de la cardiopatía dilatada como indicación de trasplante. La incidencia de infecciones en el primer año postrasplante fue de 45% (30/66). Se encontró mayor riesgo de infección en los primeros tres meses, del 36.3% (IC 95% 23 – 55), mostrando mayor frecuencia de infecciones pulmonares y en piel. Dentro de los organismos aislados más importantes en los primeros tres meses, se encontraron bacilos gram negativos y Aspergillus spp. En el primer año postrasplante la cardiopatía dilatada con un OR 4.7 IC95% (1.3 – 17) y la enfermedad renal crónica con un OR 6.7 IC 95% (1.4 - 32) se asociaron a la presencia de infecciones. Conclusiones: La frecuencia de infecciones en los pacientes trasplantados cardiacos en la Fundación Cardioinfantil IC es similar a la observada en la literatura. La aparición de infecciones en el primer año postrasplante, se asocia a la presencia de cardiopatía dilatada y enfermedad renal crónica.

Valores medioambientales en la educación : situación del futuro profesorado de Extremadura ante la ecología y el cambio climático.

Determinar la situación de los futuros maestros y maestras de Extremadura ante la ecología, el medio ambiente y el cambio climático, especialmente en referencia a sus valores, motivaciones, preocupaciones, creencias y formación previa, con el fin de poder establecer un punto de partida objetivo par el desarrollo de una Educación Ambiental multidimensional, orientada hacia una Educación en Valores Medioambientales, adaptada a sus necesidades formativas actuales y a las exigencias de la educación. Se parte de la hipótesis 'los maestros y maestras de Extremadura son conscientes de los problemas medioambientales existentes hoy en el mundo, y de la necesidad de educar para hacer frente a los mismos, pero no se encuentran suficientemente preparados para desarrollar programas de formación efectivos en el aula'. La muestra está compuesta por 192 maestros y maestras para la encuesta (40,42 por ciento de la población seleccionada), y 31 para la entrevista (6,52 por ciento) del total de la población. Se seleccionó la muestra de conveniencia, no probabilística accidental por cuota, de una población compuesta por maestros y maestras recientemente titulados (con una antigüedad máxima de un año), en ejercicio profesional o no, residentes en la Comunidad Autónoma Extremeña, ya sea en ámbito urbano o rural. Los instrumentos seleccionados con el fin de abarcar tanto técnicas de análisis cuantitativo como cualitativo, fueron un cuestionario y una entrevista, diseñados de modo específico para esta investigación, pudiendo así llevar a cabo diferentes estrategias, como los enfoques de triangulación y profundización (Mayring, 2001). La estructura del cuestionario contiene cuatro partes, la primera contiene Variables de Referencia (de donde se obtienen los datos sociodemográficos y profesionales del profesorado), la segunda sería la dimensión de estudio A (preocupación, interés, valores y creencias del profesorado en relación con la ecología, el medio ambiente y el cambio climático), la tercera parte es la dimensión del estudio B (formación básica y fenómeno de creacionismo), la cuarta y última parte es la dimensión del estudio C (nivel de confianza en colectivos e instituciones). Los datos cuantitativos obtenidos del cuestionario se han interpretado, primero estableciendo como válidos 192 de todos los cuestionarios recibidos, después se realizó el proceso de codificación y grabación,el tercer paso fue tabular las frecuencias y porcentajes, y el último paso fue el análisis cruzado, con tablas de contingencia y opcionalmente la prueba de Chi cuadrado de celda, en este proceso se han utilizado los programas Simstat, Gandia Barbwin y SPSS 12. Para la obtención de datos cualitativos se ha utilizado el método de la entrevista y para su interpretación se utilizó la estructura metodológica siguiente: primero transcripción y ordenación de la información, análisis de palabras, codificación, análisis de documento textual (método clásico) y análisis del documento textual (método de base cuantitativos), se han utilizado los siguientes programas informáticos Aquad 6, RTF y SPSS 12. Los resultados obtenidos indican que el profesorado encuestado está preocupado por la situación actual del medio ambiente y el cambio climático, causados por la actividad humana y el consumo irracional, y son conscientes de la necesidad de conservar la naturaleza. Además manifiestan una falta de formación científica básica en ecología, como lo confirman las dudas acerca de la teoría de la evolución darwiniana. Las conclusiones de la investigación indican que se ha confirmado la hipótesis planteada y se ha determinado la situación del profesorado como se pretendía al inicio de la investigación. Se concluye en cuanto a la motivación, que el futuro profesorado extremeño está interesado por los problemas medioambientales, participan de la necesidad de que existan unos valores que permitan un comportamiento adecuado con el medioambiente, la formación es el aspecto más débil en el que se encuentra este profesorado, y desde una perspectiva científica, es insuficiente. Junto con el objetivo principal se han alcanzado los siguientes objetivos secundario: se ha llevado a cabo una revisión de la literatura científica y se ha establecido el estado actual de la cuestión; se ha ofrecido un marco teórico innovador para la transformación de la Educación Ambiental en una Educación en Valores Medioambientales, con el fin de potenciar la concienciación y sensibilización de la ciudadanía; se han diseñado y validado instrumentos de investigación efectivos y solidos con los que obtener datos fiables para el objeto de estudio; se ha justificado la necesidad de una Educación Ambiental multidimensional e interdisciplinaria integrada en procesos curriculares educativos.

Impact of sewage sludge applications on the biogeochemistry of soils

This report describes an investigation into the bioavailability and fate of trace metals and their subsequent impact on important soil microbiological functions such as nitrification, denitrification and methane oxidation in low and high Cu containing soils in the presence and absence of residual organic matter from sewage sludge additions made 10 years earlier. The soils being studied are part of long term sewage sludge trials and include a low Cu soil ( 13.3mg Cu/ kg soil, 4.18 LOI %), left un- amended to serve as a control soil, soil amended with a high Cu sewage sludge ( 278.3mg Cu/ kg soil, 6.52 LOI %) and soil amended with a low Cu sewage sludge ( 46.3mg Cu/ kg soil, 6.18 LOI %). Soil was also amended with inorganic metal salts ( 273.4mg Cu/ kg soil, 4.52 LOI %) to further investigate the impact of Cu in the absence of additional organic matter contained in applied sewage sludge. Data from the first two years of a project are presented which has included field- based studies at long term sewage sludge trials based in Watlington, Oxford, UK and laboratory based studies at the Institute of Grassland & Environmental Research, North Wyke, Devon, UK.

The Bone Formation Capabilities of the Anorganic Bone Matrix-Synthetic Cell-Binding Peptide 15 Grafts in an Animal Periodontal Model: A Histologic and Histomorphometric Study in Dogs

Background: The aim of this study is to verify the regenerative potential of particulate anorganic bone matrix synthetic peptide-15 (ABM-P-15) in class III furcation defects associated or not with expanded polytetrafluoroethylene membranes. Methods: Class III furcation defects were produced in the mandibular premolars (P2, P3, and P4) of six dogs and filled with impression material. The membranes and the bone grafts were inserted into P3 and P4, which were randomized to form the test and control groups, respectively; P2 was the negative control group. The animals were sacrificed 3 months post-treatment. Results: Histologically, the complete closure of class III furcation defects was not observed in any of the groups. Partial periodontal regeneration with similar morphologic characteristics among the groups was observed, however, through the formation of new cementum, periodontal ligament, and bone above the notch. Histologic analysis showed granules from the bone graft surrounded by immature bone matrix and encircled by newly formed tissue in the test group. The new bone formation area found in the negative control group was 2.28 +/- 2.49 mm(2) and in the test group it was 6.52 +/- 5.69 mm(2), which showed statistically significant differences for these groups considering this parameter (Friedman test P <0.05). There was no statistically significant difference among the negative control, control, and test groups for the other parameters. Conclusions: The regenerative potential of ABM-P-15 was demonstrated through new bone formation circumscribing and above the graft particles. The new bone also was accompanied by the formation of new cementum and periodontal ligament fibers. J Periodontol 2010;81:594-603.

Sistema de aquisição do ciclo pressão-volume cardíaco por métodos não-invasivos

A aquisição do ciclo pressão-volume é de grande importância para diagnóstico de cardiopatias e principalmente para o acompanhamento de intervenções terapêuticas, porém os métodos hoje utilizados são caros e agressivos ao paciente, reduzindo por estes motivos sua aplicação. Este estudo pretende obter, por métodos não-invasivos, o ciclo pressão-volume do ventrículo esquerdo de pacientes humanos. Isto consiste na aquisição dos sinais P(t) e V(t) simultaneamente e a apresentação de um gráfico P(V). Para tanto, após a revisão bibliográfica, decidiu-se utilizar a ecocardiografia com detecção automática de bordos, para obtenção do volume ventricular e a medição da onda de pressão transmitida através da artéria braquial para um manguito inflado com ar, conectado a um transdutor piezo-resistivo em ponte. A aquisição da pressão pelo método não-invasivo é comparada a dados resultantes da aquisição invasiva da pressão arterial por catéter intra-aórtico que é considerado padrãoouro. Os sinais são condicionados e digitalizados em uma placa de aquisição com conversor A/D de 8 bits e micro controlador 80c196. Os dados digitalizados são então enviados serialmente para um computador onde são gerados os gráficos. Obteve-se de cinco pacientes nove aquisições simultâneas da pressão invasiva através de catéter intra-aórtico e do protótipo desenvolvido resultando concordância segundo o método de Bland e Altman (1986) (r=0,989; d + 2s= 6,52; d - 2s =-6,07), comprovando a eficiência do método de aquisição. Obteve-se resultado satisfatório também quanto à operação sistema desenvolvido pois foram realizadas dez aquisições em cinco pacientes, registrando-se gráficos bastante similares aos apresentados na literatura disponível.

A pessoa idosa com doença crônica não transmissível atendida em serviços de média complexidade na cidade de Natal/RN

The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases

Avaliação da relação entre qualidade de sono e uma intervenção com jogos para o desempenho de crianças e adolescentes

The sleep is an active brain process that allows the efficient realization of daily tasks. The changes on sleep patterns may influence the different cognitive processes performance. Many recent studies show the possibility of cognitive performance improvement, through the cognitive training with the use of computer games. The question is if these interventions may be influenced by the sleep quality. Thus, we evaluated the sleep quality effect about the efficacy of an intervention with computers games based on the working memory and attention for a cognitive performance training of elementary school students. The sample was constituted by 42 students with average age of 10,43 years old (SD=1,23), with 22 male participants and 20 female participants. We used to evaluate the sleep with the parents a sleep questionnaire, a sleep diary and the Sleep Behavior Questionnaire. In regard to intervention, the subjectives were distributed in an experimental and in a control group, both with 21 participants. In the first group occurred the intervention that consisted in the working memory and attention training with two cognitive tasks (Safari e Brain Workshop) during 30 daily minutes, for a 6 weeks period. In an equal period, the students from the control group should reproduce an artwork using drawing software. To evaluate the cognitive performance we applied before and after the intervention period the Wechsler Intelligence Scale for Children (WISC-III). The results showed that in both the groups the performance of the intelligence, working memory, attention and visuospatial skills was below of the mean. The cognitive processes evaluated after of intervention in the experimental group had a performance significantly higher in the Perceptual Reasoning Index (t = -6,24; p < 0,01) and in the Full Scale IQ (t = -5,09; p < 0,01) and Performance IQ (t = -6,52; p < 0,01), suggesting a improvement on the visuospatial skills, attention, working memory and processing speed. On the control group, the performance was significantly higher in the Coding subtest (t = -5,38; p< 0,01) and in the Perceptual Reasoning Index (t = -3,66; p = 0,01), suggesting a improvement on the visuospatial skills and attention. The mean obtained with the Sleep Behavior Questionnaire was 53,76 (SD=14,96) for an experimental group and 61,19 (SD=12,82) for a control group, indicating tendency for a bad sleep quality in that last one. Not only during the first days, but also in the last fifteen days of the intervention we verified in the two groups an adequate time to sleep, duration and regularity, in the weekdays and on the weekends. We didn t find significant differences between the two groups in none of the sleep variables. We verified statistically meaningful improvement on the performance of the experimental group with the intervention in the two games. We didn t verify significant correlations between the games performance index and in the sleep variables of the experimental group individuals. We verified significant correlations among the performance on the Brain Workshop and the Cubes subtest, the Perceptual Reasoning Index and the Scale Performance IQ, suggesting that the significant improvement of the visuospatial skills and of the attention was correlated with the performance in the Brain Workshop. Although the absence of correlations with the performance in the Safari, possibly it also has relieved in the improvement of the cognitive performance. The findings support the hypothesis that the computer games might be a satisfactory tool for the improvement of the performance in visuospatial skills and attention. This can be resulted of the insertion of visuospatial stimulations in the task, for example, graphical elements with thematic for children that increase the interest. The IQ below mean the individuals might have influenced the improvement absence on the cognitive processes like the working memory with games. Moreover, it wasn t verified a relation between the sleep quality and the intervention efficacy. It might have been influenced by the n of the sample. Future studies must focalize in the improvement of the effect of the interventions with games

Índices técnicos correspondentes à velocidade crítica e à máxima velocidade de 30 minutos em nadadores com diferentes níveis de performance aeróbia

O principal objetivo deste estudo foi verificar o efeito do nível de performance aeróbia na relação entre os índices técnicos correspondentes à velocidade crítica (VC) e à velocidade máxima de 30 minutos (V30) em nadadores. Participaram deste estudo, 23 nadadores do gênero masculino com características antropométricas similares, divididos segundo o nível de performance aeróbia em grupo G1 (maior performance) (n = 13) e G2 (menor performance) (n = 10). Os indivíduos tinham pelo menos quatro anos de experiência no esporte e treinavam um volume semanal de 30.000 a 45.000m. A VC foi determinada através do coeficiente angular da regressão linear entre as distâncias (200 e 400m) e seus respectivos tempos. A V30 foi determinada através da máxima distância realizada em um teste de 30 minutos. Todas as variáveis foram determinadas no nado crawl. A VC foi significantemente maior do que a V30 no grupo G1 (1,30 ± 0,04 vs. 1,23 ± 0,06m.s-1) e no G2 (1,17 ± 0,08 vs. 1,07 ± 0,06m.s-1). As duas variáveis foram maiores no grupo G1. As taxas de braçada correspondentes à VC (TBVC) e à V30 (TBV30) obtidas nos grupos G1 (33,07 ± 4,34 vs. 31,38 ± 4,15 ciclos.min-1) e G2 (35,57 ± 6,52 vs. 33,54 ± 5,89 ciclos.min-1) foram similares entre si. A TBVC foi significantemente menor no grupo 1 do que no grupo 2, enquanto que a TBV30 não foi diferente entre os grupos. Os comprimentos de braçada correspondentes à VC (CBVC) e à V30 (CBV30) foram significantemente maiores no grupo G1 (2,41 ± 0,33 vs. 2,38 ± 0,30m.ciclo-1) do que no G2 (2,04 ± 0,43 vs. 1,97 ± 0,40m.ciclo-1), e similares entre si nos dois grupos. As correlações (r) entre a VC e a V30 e as variáveis técnicas correspondentes às duas velocidades foram significantes em todas as comparações (0,68 a 0,91). Portanto, a relação entre a velocidade e as variáveis técnicas correspondentes à VC e à V30 não é modificada pelo nível de performance aeróbia.

Energy and oil levels in broiler starter diets

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

Spontaneous resolution rates of vesicoureteral reflux in Brazilian children: A 30-year experience

Objective: We evaluated clinical characteristics of primary vesicoureteral reflux (VLJR) in infants in a 30-year period in Brazil with special reference to the relation of renal parenchymal damage to urinary tract infection and gender. Materials and Methods: From 1975 through 2005, 417 girls (81.6%) and 94 boys (18.4%) with all grades of reflux were retrospectively reviewed. Patients were categorized by the worst grade of reflux, maintained on antibiotic prophylaxis and underwent yearly voiding cystourethrography until the reflux was resolved. VUR was considered resolved when a follow-up cystogram demonstrated no reflux. Surgical correction was recommended for those who fail medical therapy, severe renal scarring or persistent VUR. Results: Grades I to V VUR resolved in 87.5%, 77.6%, 52.8%, 12.2% and 4.3%, respectively. Renal scars were present at presentation in 98 patients (19.2%). Neither gender nor bilaterality versus unilaterality was a helpful predictor of resolution. The significant difference was found among the curves using the log rank (p < 0.001) or Wilcoxon (p < 0.001) test. Conclusion: Despite the current use of screening prenatal ultrasound, many infants are still diagnosed as having vesicoureteral reflux only after the occurrence of urinary tract infection in our country. Scarring may be associated to any reflux grade and it may be initially diagnosed at any age but half of the scars are noted with higher grades of reflux (IV and V). The incidence of reflux related morbidity in children has significantly diminished over the last three decades.

Diversidade e composição de formigas Ponerines (Hymenoptera, Formicidae, Ponerinae) de Serapilheira na Estação Científica Ferreira Penna, Caxiuanã, Melgaço, Pará, Brasil

Inventários da mesofauna de solo e serapilheira em florestas tropicais apresentam a subfamíliaC (Hymenoptera, Formicidae) como uma das mais conspícuas e a segunda com maior riqueza e abundância, depois da subfamília Myrmicinae. Nestes ambientes, as ponerines constituem componentes ecologicamente importantes, onde são notáveis predadoras de outros invertebrados e podem nidificar nos troncos em decomposição ou na serapilheira. Este estudo foi realizado com a intenção de investigar a distribuição espacial das espécies de formigas da subfamília Ponerinae associadas à serapilheira, considerando sua abundância, riqueza, diversidade e composição, em seis áreas de floresta primária (Áreas I, II, III, IV, V e VI) na Estação Científica Ferreira Penna (ECFPn), Caxiuanã, Melgaço, Pará; e como a quantidade de serapilheira influencia nessa distribuição. Este estudo resulta de três coletas realizadas pelo Protocolo de Monitoramento de Formigas do Projeto TEAM/Caxiuanã entre abril de 2003 e janeiro de 2004. Coletaram-se 720 sub-amostras de 1 m² de serapilheira, distribuídas em 72 transectos de 100 m (unidade amostral) entre as seis áreas durante as coletas (quatro transectos por área em cada coleta), utilizando extratores de mini-Winkler. Identificaram-se 4.031 exemplares, pertencentes às três tribos, oito gêneros e 60 espécies de Ponerinae em 470 registros, sendo que o número médio de espécies por amostra foi de 6,52, e estimou-se encontrar 81 espécies (Jackknife 1). Hypoponera foi o gênero com maior abundância (268 registros) e riqueza de espécies (22), compreendendo junto com Pachycondyla mais de 70% das espécies. A Área V apresentou maior diversidade (H= 3,30), abundância (121) e riqueza (38) em espécies, além de maior volume de serapilheira (ANOVA; p<0,05 entre a Área V e as demais). A quantidade de serapilheira afetou positivamente a abundância e a riqueza de espécies, e também influenciou na composição de espécies. As espécies mais freqüentes (abundantes) nas amostras foram Hypoponera sp#1, Hypoponera sp#2, Hypoponera sp#6, Hypoponera sp#7, dontomachus scalptus e Pachycondyla constricta, que juntas representaram mais de 50% da abundância total. No geral, as ponerines apresentaram ampla distribuição na serapilheira de floresta primária na ECFPn, sendo numericamente influenciadas pela quantidade de serapilheira; as áreas apresentaram diferenças na diversidade, abundância e riqueza das espécies encontradas; e, como efeito do elevado número de espécies raras, encontrou-se baixa similaridade na composição de espécies entre amostras próximas; logo, mesmo em pequena escala, a heterogeneidade da camada de serapilheira na floresta amazônica tem importante papel na distribuição das espécies.