O paciente com infecção de vias aéreas superiores. Quando anestesiar?

JUSTIFICATIVA E OBJETIVOS: Anestesiar, com segurança, a criança com infecção de vias aéreas superiores (IVAS) constitui um dos grandes desafios do anestesiologista. A finalidade deste artigo é discutir a validade de anestesiar e quando anestesiar a criança com IVAS. CONTEÚDO: Estão ressaltados a importância da história clínica na investigação pré-operatória, os fatores que contribuem para o aparecimento de complicações no per e no pós-operatório, assim como o tipo de cirurgia e a técnica anestésica que favorecem estas complicações. CONCLUSÕES: O conhecimento das alterações no trato respiratório que acontecem após IVAS, da importância da avaliação correta da gravidade dos sintomas, dos fatores que podem contribuir para o aparecimento de complicações e da melhor técnica anestésica possibilita a seleção de pacientes com menor risco de desenvolver complicações no período per-operatório.

Levels of toxic and essential metals in maternal and umbilical cord blood from selected areas of South Africa-results of a pilot study

This pilot study uses concentrations of metals in maternal and cord blood at delivery, in seven selected geographical areas of South Africa, to determine prenatal environmental exposure to toxic metals. Samples of maternal and cord whole blood were analysed for levels of cadmium, mercury, lead, manganese, cobalt, copper, zinc, arsenic and selenium. Levels of some measured metals differed by site, indicating different environmental pollution levels in the regions selected for the study. Mercury levels were elevated in two coastal populations studied (Atlantic and Indian Ocean sites) with mothers from the Atlantic site having the highest median concentration of 1.78 mu g/L ranging from 0.44 to 8.82 mu g/L, which was found to be highly significant (p < 0.001) when compared to other sites, except the Indian Ocean site. The highest concentration of cadmium was measured in maternal blood from the Atlantic site with a median value of 0.25 mu g/L (range 0.05-0.89 mu g/L), and statistical significance of p < 0.032, when compared to all other sites studied, and p < 0.001 and p < 0.004 when compared to rural and industrial sites respectively, confounding factor for elevated cadmium levels was found to be cigarette smoking. Levels of lead were highest in the urban site, with a median value of 32.9 mu g/L (range 16-81.5 mu g/L), and statistically significant when compared with other sites (p < 0.003). Levels of selenium were highest in the Atlantic site reaching statistical significance (p < 0.001). All analysed metals were detected in umbilical cord blood samples and differed between sites, with mercury being highest in the Atlantic site (p < 0.001), lead being highest in the urban site (p < 0.004) and selenium in the Atlantic site (p < 0.001). To the best of our knowledge this pilot investigation is the first study performed in South Africa that measured multiple metals in delivering mothers and umbilical cord blood samples. These results will inform the selection of the geographical sites requiring further investigation in the main study.

Faixas de proteção ambiental do Rio Pitimbu/RN: uma análise como subsídio ao planejamento e ordenamento do território

The Environmental Protection area sof Pitimbu river are important tools for planning and territorial land management. The Pitimbu river protection is aided in laws, so much of Federal stamp, as the Brazilian s Forest Code (Law No. 4771/1965), and in State s and City s Resolutions. So, this research begins in the State s Law No. 8426/2003interpretations, for being the most restrictive in the river's margin occupation and management. The objective is to analyze the applicability of the Environmental Protection areas of Pitimbu river, localized at the State of Rio Grande do Norte, considering environmental legislation and how to use this space by the man. Having specific goals for the discussion of the legislation s scope to this river; the identification of the types of soil s covering and evaluation the effectiveness of Law Nº.8426/2003, as protection instrument and land management. The river is characterized by its ecological importance and for feeding the Jiqui pond, an important reservoir that supplies 30% of drinking water to the east, west and south population sof the capital of the State. Pitimbu river is passing by a process of environmental degradation, originating from actions as deforestations of its ciliary forests by intensive agricultural practices; introduction of urban and industrial effluents leading to its contamination; increase of the pluvial drainage; erosion, sedimentation and discharge of urban waste , along with pressure for urban settlements along its banks. Under the methodological point of view is part of theoretical planning and land management research, and from a vision of social and environmental spaces. It was produced a survey map of the soil s covering, with 16 classes. Divided into coverage and disturbed natural covering. Using the 300 meters spatial limits of the Environmental Protection Strip, according to the State Law. The survey highlighted a higher percentage of classes disturbed, indicating man s interference in the balance of that system, as well as the lack of environmental actions. Leading to the degradation of riparian areas, and lack of conservation of water resources. Finally, it was considered that the strips of environmental protection are not effective as the preservation and territorial ordination

Toxic and essential elements in blood from delivering women in selected areas of São Paulo State, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Levels of selected persistent organic pollutants in blood from delivering women in seven selected areas of São Paulo State, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Spatial distribution of trachoma cases in the City of Bauru, State of São Paulo, Brazil, detected in 2006: defining key areas for improvement of health resources

Introduction: The objective of this study was to analyze the spatial behavior of the occurrence of trachoma cases detected in the City of Bauru, State of São Paulo, Brazil, in 2006 in order to use the information collected to set priority areas for optimization of health resources. Methods: the trachoma cases identified in 2006 were georeferenced. The data evaluated were: schools where the trachoma cases studied, data from the 2000 Census, census tract, type of housing, water supply conditions, distribution of income and levels of education of household heads. In the Google Earth® software and TerraView® were made descriptive spatial analysis and estimates of the Kernel. Each area was studied by interpolation of the density surfaces exposing events to facilitate to recognize the clusters. Results: of the 66 cases detected, only one (1.5%) was not a resident of the city's outskirts. A positive association was detected of trachoma cases and the percentage of heads of household with income below three minimum wages and schooling under eight years of education. Conclusions: The recognition of the spatial distribution of trachoma cases coincided with the areas of greatest social inequality in Bauru City. The micro-areas identified are those that should be prioritized in the rationalization of health resources. There is the possibility of using the trachoma cases detected as an indicator of performance of micro priority health programs.

Alterações orofaciais em doenças alérgicas de vias aéreas

OBJETIVO: Apontar as possíveis alterações orofaciais decorrentes do sintoma obstrução nasal em pacientes portadores de doenças alérgicas de vias aéreas superiores, por meio de revisão de literatura. FONTES DE DADOS: Levantamento bibliográfico utilizando bancos de dados eletrônicos, como Medline, Ovid, SciELO e Lilacs, com as palavras-chave asthma, rhinitis e mouth breathing, abrangendo os 30 últimos anos. Foram incluídos artigos de revisão, estudos observacionais e ensaios clínicos. SÍNTESE DOS DADOS: A obstrução nasal é encontrada freqüentemente em doenças alérgicas de vias aéreas, como rinite e asma. A respiração bucal decorrente da obstrução nasal pode interferir de maneira direta no desenvolvimento infantil, com alterações no crescimento do crânio e orofacial, na fala, na alimentação, na postura corporal, na qualidade do sono e no desempenho escolar. CONCLUSÕES: Devido à variedade de alterações orofaciais encontradas na criança respiradora bucal decorrente de obstrução nasal por doenças alérgicas de vias aéreas, é necessário realizar diagnóstico e tratamento precoces por uma equipe multidisciplinar, composta por médico, ortodontista e fonoaudiólogo, contemplando a visão de uma via respiratória única, que traz conseqüências ao crescimento e desenvolvimento do sistema motor oral.

High frequency of Paracoccidioides brasiliensis infection in armadillos (Dasypus novemcinctus): an ecological study

The fungus Paracoccidioides brasiliensis has been isolated from nine-banded armadillos (Dasypus novemcinctus) in different regions where paracoccidiodomycosis (PCM) is endemic. The link between PCM and these animals has provided the first valuable clue in the effort to elucidate the ecological niche of P. brasiliensis. The present study was aimed at correlating P. brasiliensis infection in armadillos with local ecological features and, if possible, the presence of the fungus in the soil in the Botucatu hyperendemic area of PCM. In this region the mean temperature ranges from 14.8 to 25.8degreesC and the annual average precipitation is 1520 mm. The sites where 10 infected animals (positive group) were collected were studied and compared with the sites where five uninfected animals were found. The occurrence of the fungus in soil samples collected from the positive armadillos' burrows and foraging sites was investigated by the indirect method of animal inoculation. Environmental data from the sites of animal capture, such as temperature, rainfall, altitude, vegetation, soil composition, presence of water and proximity of urban areas, were recorded. All 37 soil samples collected from the sites had negative fungal cultures. Positive animals were found much more frequently in sites with disturbed vegetation, such as riparian forests and artificial Eucalyptus Or Pinus forests, in altitudes below 800 m, near water sources. The soil type of the sites of positive animals was mainly sandy, with medium to low concentrations of organic matter. The pH was mainly acidic at all the sites, although the concentrations of aluminum cations (H+Al) were lower at the sites where positive animals were found. Positive armadillos were also captured in sites very close to urban areas. Our data and previous studies indicate that P. brasiliensis occurs preferentially in humid and shady disturbed forests in a strong association with armadillos.

Leishmania spp. and/or Trypanosoma cruzi diagnosis in dogs from endemic and nonendemic areas for canine visceral leishmaniasis

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

Age-related changes in muscle fiber type frequencies and cross-sectional areas in straightbred and crossbred rabbits

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

Hepatozoon canis infection associated with dog ticks of rural areas of Rio de Janeiro State, Brazil

Hepatozoon canis is a tick-borne protozoan that infects dogs and has been reported throughout the world. Manifestation of H. canis infection varies from being sub-clinical in apparently healthy dogs to severe illness. The main vector of the infection is the dog tick, Rhipicephalus sanguineus although other species may also transmit this agent. H. canis has been reported previously in Brazil, but mostly as an occasional finding during laboratory exams and always associated with other diseases. The prevalence of H. canis in dogs of rural areas of Brazil has been little studied. For this study, 250 dogs from seven counties of Rio de Janeiro state were examined. All the dogs were from rural areas, near forest. of the dogs examined, 26 dogs were from Seropedica, 82 from Itaguai, 41 from Paracambi, 26 from Mangaratiba, 32 from Barra do Pirai, 32 from Pirai and 11 from Miguel Pereira. Blood smears from the peripheral blood of the ear were taken and ticks found on the dogs were collected for identification in the laboratory. Using blood smear evaluation, H. canis was identified in 39.2% of the animals examined. Other hemoparasites identified were Babesia canis (5.2%) and Ehrlichia canis (4.8%). Four tick species were found parasitizing the dogs: Amblyomma cajennense (23.6%), R. sanguineus (12.4%), Amblyomma aureolatum (2.8%) and Amblyomma ovale (2.0%). There was a positive correlation between the presence of A. cajennense and H. canis infection. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Babesia spp. infection in dogs from rural areas of São Paulo State, Brazil

The status of Babesia spp. infection in dogs from rural areas of São Paulo State, Brazil was Studied. For this, l 50 animals were examined by blood smears and by PCR; the presence of tick infestation was also investigated. By the blood smear examination, 3 animals (2%) were detected positive and by PCR for Babesia spp. 12 (8%) were positive, with bands Visualized in 450 bp. Rhipicephalus sanguineus or Amblyomma spp. were found on 36 (24%) of the 150 dogs. Amblyomma species found were A. cajennense (9/36-25%) and A. ovale (9/36-25%). It was not possible to correlate the presence of R. sanguineus and the infection with Babesia spp. The sequencing of four positive samples demonstrated close identity with B. canis vogeli already characterized in Brazil.

Input of litter in deforested and forested areas of a tropical headstream

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)