Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

Topografia do cone medular da paca (Agouti paca, Linnaeus - 1766)

We object in this work to determine the skeleton sintopy of the medular cone termination of the paca relating to the lumbar and sacral vertebrae, thus aiming at establishing morphometric and topographical parameters of the medular cone in this specie. We accomplished the dissection through skin incision, subcutaneous divulsion and dissection of the vertebral column dorsal region musculature, sectioning and removing the vertebrae arcs for better visualization of the spinal medulla. After the individualization of the medular cone, we registered the anatomical aspects of interest, emphasizing the basis and its apex in relation to the vertebrae, following the measuring of the region using a caliper rule; photographs and schematic drawing were made to register the findings of studied specimens.

Cortisol response to acute stress in jundiá Rhamdia quelen acutely exposed to sub-lethal concentrations of agrichemicals

Exposure to agrichemicals can have deleterious effects on fish, such as disruption of the hypothalamus-pituitary-inter-renal axis (HPI) that could impair the ability of fish to respond to stressors. In this study, fingerlings of the teleost jundiá (Rhamdia quelen) were used to investigate the effects of the commonly used agrichemicals on the fish response to stress. Five common agrichemicals were tested: the fungicide - tebuconazole, the insecticide - methyl-parathion, and the herbicides - atrazine, atrazine + simazine, and glyphosate. Control fishes were not exposed to agrichemicals and standard stressors. In treatments 2-4, the fishes were exposed to sub-lethal concentrations (16.6%, 33.3%, and 50% of the LC50) of each agrichemical for 96 h, and at the end of this period, were subjected to an acute stress-handling stimulus by chasing them with a pen net. In treatments 5-7 (16.6%, 33.3%, and 50% of the LC50), the fishes were exposed to the same concentrations of the agrichemicals without stress stimulus. Treatment 8 consisted of jundiás not exposed to agrichemicals, but was subjected to an acute stress-handling stimulus. Jundiás exposed to methyl-parathion, atrazine + simazine, and glyphosate presented a decreased capacity in exhibiting an adequate response to cope with stress and in maintaining the homeostasis, with cortisol level lower than that in the control fish (P < 0.01). In conclusion, the results of this study clearly demonstrate that the acute exposure to sub-lethal concentrations of methyl-parathion, atrazine + simazine, and glyphosate exert a deleterious effect on the cortisol response to an additional acute stressor in the jundiá fingerlings. © 2008 Elsevier Inc. All rights reserved.

Thermoplasticity of microseal and TC gutta-percha (Tanaka de Castro) and three gutta-percha cones

Aim: The aim of this study was to assess the thermoplasticity of materials used in root canal filling. Methods: Specimens with standardized dimensions were fabricated using Tanari, Roeko and Activ Point gutta-percha cones, as well as Microseal and TC gutta-percha. After 24 hours, the specimens were placed in water at 70 °C for 60 seconds and positioned between two glass slabs. Each set was compressed by a 5 g weight. Digital images of the specimens before and after compression were obtained and analyzed. The thermoplasticity was evaluated based on the difference between the final and initial areas. Data were statistically analyzed using ANOVA and Tukey's tests at a 5% significance level. Results: TC and Microseal gutta-percha presented the highest thermoplasticity (p < 0.05). Among the gutta-percha cones, Tanari and Roeko presented the highest thermoplasticity and differed when compared to Activ Point (p < 0.05). Conclusions: The results of the present study showed that TC and Microseal gutta-percha filling systems present better thermoplastic properties.

Folha rota, de Machado de Assis: Mulheres livres e pobres na ordem patriarcal

This article analyzes the short story Folha rota (1878) by Machado de Assis, taking to account the transformation process of the patriarchy, bearing in mind it's decadence within the increasing urbanization context through 19th century. From the representation of female characters and their everyday's life in the narrative, we discuss the violence experienced by free and poor women involved in the inherent power relations in that society. In this perspective, we intend to indicate an interpretation of literary work as an important device of social criticism, as much as, to give a contribution to an accurate comprehension of Machado de Assis's work, especially his short stories.

Dornase alfa improves the health-related quality of life among Brazilian patients with cystic fibrosis - A one-year prospective study

Background: Health-related quality of life (HRQOL) measurements provide valuable information about the psychological and social impact of treatment on patients with cystic fibrosis (CF). This study evaluated the HRQOL of Brazilian patients with CF and assessed the changes in HRQOL domains over 1 year after dornase alfa (Pulmozyme) introduction. Patients and Methods: One hundred fifty-six stable patients with CF and 89 caregivers answered the Portuguese-validated version of the Cystic Fibrosis Questionnaire-Revised (CFQ-R) at baseline (T 0), and at 3 (T 1), 6 (T 2), 9 (T 3), and 12 (T 4) months of follow-up. Eighteen patientswere excluded because they did not fulfill the inclusion criteria. The patients were analyzed in two groups: those aged 6-11 years and those aged 14 years and older. ANOVA for observed repeated results and the last observation carried forward (LOCF) method for missing data were used for the statistical analysis. Results: After 1 year of follow-up, there was significant improvement in respiratory symptoms (T 4-T 0=8.1; 95% confidence interval (95% CI)=[2.1;14.0]; effect size (ES)=0.35; P<0.001), Emotional Functioning (T 4-T 0=5.6; 95% CI=[1.1;10.1]; ES=0.31; P<0.05), Social Functioning (T 4-T 0=6.0; 95% CI=[1.3;11.7]; ES=0.31; P<0.05), Body Image (T 4-T 0=11.9; 95% CI=[4.1;19.7]; ES=0.42; P<0.05), and Treatment Burden (T 4-T 0=5.3; 95% CI=[0.3;10.3]; ES=0.24; P<0.05) domains in the younger group. A significant improvement in Role Functioning (T 4-T 0=6.1; 95% CI=[1.1;11.1]; ES=0.40; P<0.05), Body Image (T 4-T 0=12.6; 95% CI=[3.5;21.7]; ES=0.46; P<0.05), and Weight (T 4-T 0=11.7; 95% CI=[1.8;21.6]; ES=0.40; P<0.05) was obtained in the older group. The caregivers' CFQ-R showed improvements in the Digestive Symptoms (T 4-T 0=5.5; 95% CI=[1.5;9.4]; ES=0.30; P<0.05), Respiratory Symptoms (T 4-T 0=7.6; 95% CI=[3.9;11.4]; ES=0.48; P<0.05), and Weight (T 4-T 0=10.1; 95% CI=[1.6;18.6]; ES=0.26; P<0.05) domains. Conclusion: The introduction of dornase alfa improved the HRQL of the patients with CF during the first year of treatment. © 2010 Wiley-Liss, Inc.

Intravascular lymphomatosis in the central nervous system of dogs: Immunohistochemical investigation in two cases

We report here two postmortem cases of dogs with intravascular lymphomatosis affecting the central nervous system. Intravascular lymphomatosis is represented by an exclusively intravascular proliferation of neoplastic lymphoid cells. To characterize the origin of the neoplastic cells, we have proceeded with immunohistochemical analysis to identify B and T lymphocytes and endothelial cells. The results showed predominance of cells from the T cell lineage, and no evidence of B cell origin was found. Few cells from one dog also exhibited cytoplasmatic staining for vimentin and Von Willebrand factor. Although in one case some immunophenotype diversity was observed, the massive presence of CD3 positive cells confirmed these neoplasms as intravascular lymphomatosis of T cell origin.

Is the environmental policies procedures a barrier to development of inland navigation and port management? A case of study in Brazil

The main objective of this article is to discuss the Brazilian environmental legislation and policies towards the development of navigation and port management. The research illustrated some difficulties faced by the country and make suggestions to overcome it. The construction of the environmental legal framework began in the early 1960s and resulted in a very complex system, as a consequence of policies adopted by the country. Nowadays Brazilian environmental policies are developed in democratic and participative way, although with elevated degree of bureaucracy and lack of integration among the several governmental agencies, which makes the approval of environmental certifications demand several years for new port projects or improvements, which delays the economic development of the country. Efforts have been made to simplify the licensing process. As result of this research two flowchart for environmental licenses of ports installation are shown: The first shows the process until 2009 and the second shows the process nowadays. This become an important issue due the fact that inland navigation is one of the less pollutant modes of transportation, and although, the process of environmental certification was simplified, if compare with 2009, it is still complex and time-consuming, delaying the development of the infrastructure. © 2012 Elsevier Ltd.

Monitoring in precision metal drilling process using multi-sensors and neural network

This paper presents a new method to estimate hole diameters and surface roughness in precision drilling processes, using coupons taken from a sandwich plate composed of a titanium alloy plate (Ti6Al4V) glued onto an aluminum alloy plate (AA 2024T3). The proposed method uses signals acquired during the cutting process by a multisensor system installed on the machine tool. These signals are mathematically treated and then used as input for an artificial neural network. After training, the neural network system is qualified to estimate the surface roughness and hole diameter based on the signals and cutting process parameters. To evaluate the system, the estimated data were compared with experimental measurements and the errors were calculated. The results proved the efficiency of the proposed method, which yielded very low or even negligible errors of the tolerances used in most industrial drilling processes. This pioneering method opens up a new field of research, showing a promising potential for development and application as an alternative monitoring method for drilling processes. © 2012 Springer-Verlag London Limited.

Carta de Valdés Rodríguez de la Delegación de Cuba al Dr. Luis machado y Ortega Presidente de la II Sesión de la Comisión Económica para América Latina

Solicita la inclusión en la Agenda de la Conferencia del tema "Turismo"

Letter of Valdés Rodriguez President of the Cuban Delegation to Dr. Luis Machado y Ortega President of the Second Session of the Economic Commission for Latin America

Request the inclusion into the Agenda of the Conference of the item "Turismo"

Carta de Alberto Baltra C. Presidente de la Delegación de Chile al Dr. Luis Machado, Presidente de la Comisión Económica para América Latina

Sugiere introducir algunas modificaciones al Reglamento para lograr una mayor eficiencia en la labor de la Comisión

Letter of Alberto Baltra C. President of the Delegation of Chile to Dr. Luis Machado, Chairman of the Economic Commission for Latin America

Sugest introduce certain amendments in the Rules of Procedure, in order to make the work of the Commission more efficient