The role of membranous urethral afferent autonomic innervation in the continence mechanism after nerve sparing radical prostatectomy: a clinical and prospective study

Purpose: We evaluated the somatic and autonomic innervation of the pelvic floor and rhabdosphincter before and after nerve sparing radical retropubic prostatectomy using neurophysiological tests and correlated findings with clinical parameters and urinary continence. Materials and Methods: From February 2003 to October 2005, 46 patients with prostate cancer were enrolled in a controlled, prospective study. Patients were evaluated before and 6 months after nerve sparing radical retropubic prostatectomy using the UCLA-PCI urinary function domain and neurophysiological tests, including somatosensory evoked potential, and the pudendo-urethral, pudendo-anal and urethro-anal reflexes. Clinical parameters and urinary continence were correlated with afferent and efferent innervation of the membranous urethra and pelvic floor. We used strict criteria to define urinary continence as complete dryness with no leakage at all, not requiring any pads or diapers and with a UCLA-PCI score of 500. Patients with a sporadic drop of leakage, requiring up to 1 pad daily, were defined as having occasional urinary leakage. Results: Two patients were excluded from study due to urethral stricture postoperatively. We evaluated 44 patients within 6 months after surgery. The pudendo-anal and pudendo-urethral reflexes were unchanged postoperatively (p = 0.93 and 0.09, respectively), demonstrating that afferent and efferent pudendal innervation to this pelvic region was not affected by the surgery. Autonomic afferent denervation of the membranous urethral mucosa was found in 34 patients (77.3%), as demonstrated by a postoperative increase in the urethro-anal reflex sensory threshold and urethro-anal reflex latency (p <0.001 and 0.0007, respectively). Six of the 44 patients used pads. One patient with more severe leakage required 3 pads daily and 23 showed urinary leakage, including 5 who needed 1 pad per day and 18 who did not wear pads. Afferent autonomic denervation at the membranous urethral mucosa was found in 91.7% of patients with urinary leakage. Of 10 patients with preserved urethro-anal reflex latency 80% were continent. Conclusions: Sensory and motor pudendal innervation to this specific pelvic region did not change after nerve sparing radical retropubic prostatectomy. Significant autonomic afferent denervation of the membranous urethral mucosa was present in most patients postoperatively. Impaired membranous urethral sensitivity seemed to be associated with urinary incontinence, particularly in patients with occasional urinary leakage. Damage to the afferent autonomic innervation may have a role in the continence mechanism after nerve sparing radical retropubic prostatectomy.

Alimentação de Serrasalmus maculatus (Kner, 1858) (characiformes; serrasalmidae) no trecho inferior bacia do rio Sorocaba, São Paulo, Brasil

The aim of this study was to discuss aspects of the diet of Serrasalmus maculatus. Fish were collected using gill nets, whose lengths measured 100 m and mesh diameters varied from 3 to 8 cm. A total of 107 individuals were collected. Their length varied from 62 to 210 mm. They were mainly represented by female and immature individuals. No individual was caught in temperatures below 21°C. Four feeding item categories were observed: fish muscle pieces, parts of fish fins, plant fragments, and insects. Comparisons made among individual length classes revealed some significant differences within stomach consumed contents. Individuals whose length exceeded 165 mm consumed only parts of fish muscles and plants. The food availability in the environment and the class lengths amplitude may, however, have influenced the results, in which ontogenetic differences should not be precisely observed.

Effect of radiotherapy on the radiopacity and flexural strength of a composite resin.

The aim of this study was to evaluate the effect of radiotherapy on the radiopacity and flexural strength of composite resin. Forty Z250 composite resin specimens were polymerized using a halogen light-curing unit and divided into 5 groups, in accordance with the radiotherapy dose: G1- without irradiation, G2- 30 Gy, G3- 40 Gy, G4- 50 Gy and GS- 60 Gy Digital images were obtained using a GE 100 X-ray. Radiopacity values were obtained with the Digora digital imaging system and the flexural strength was evaluated with an EMIC universal testing machine. Data were submitted to ANOVA and Tukey 's test. G1 presented the highest radiopacity value, followed by G3, G5, G4 and G2. For flexural strength, G1 presented the lowest value, followed by G2, G5, G3 and G4. Differences were no significant (p>0.05). The commonly used dosage of radiotherapy treatment, did not cause alteration in the radiopacity and flexural strength of resin-based composites.

MERCOSUL: avanços e desafios da integração

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Analysis of polymerization time on abrasive wear of dental resins

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

Design of a state observer using decay rate LMI constraints for fault detection in mechanical systems

Nowadays, one of the most important concerns for many companies is to maintain the operation of their systems without sudden equipment break down. Because of this, new techniques for fault detection and location in mechanical systems subject to dynamic loads have been developed. This paper studies of the influence of the decay rate in the design of state observers using LMI for fault detection in mechanical systems. This influence is analyzed by the performance index proposed by Huh and Stein for the condition of a state observer. An example is presented to illustrate the methodology discussed.

Sostenibilidad del desarrollo en América Latina y el Caribe: cifras y tendencias, Honduras

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La gran transición: la promesa y la atracción del futuro

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Colombia: cuenta de seguridad social

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Programas de apoyo a las micro, pequeñas y medianas empresas en México, 1995-2000

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Investimentos externos em serviços e efeitos potenciais da negociação da ALCA

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Lidar observation campaign of sugar cane fires and industrial emissions in the State of São Paulo, Brazil

Brazil has an important role in the biomass burning, with the detection of approximately 100,000 burning spots in a single year (2007). Most of these spots occur in the southern part of the Amazon basin during the dry season (from August to november) and these emissions reach the southeast of the country, a highly populated region and with serious urban air pollution problems. With the growing demand on biofuels, sugarcane is considerably expanding in the state of São Paulo, being a strong contributor to the bad air quality in this region. In the state of São Paulo, the main land use are pasture and sugarcane crop, that covers around 50% and 10% of the total area, respectively. Despite the aerosol from sugarcane burning having reduced atmospheric residence time, from a few days to some weeks, they might get together with those aerosol which spread over long distances (hundreds to thousands of kilometers). In the period of June through February 2010 a LIDAR observation campaign was carried in the state of São Paulo, Brazil, in order to observe and characterize optically the aerosols from two distinct sources, namely, sugar cane biomass burning and industrial emissions. For this purpose 2 LIDAR systems were available, one mobile and the other placed in a laboratory, both working in the visible (532 nm) and additionally the mobile system had a Raman channel available (607 nm). Also this campaign counted with a SODAR, a meteorological RADAR specially set up to detect aerosol echoes and gas-particle analyzers. To guarantee a good regional coverage 4 distinct sites were available to deploy the instruments, 2 in the near field of biomass burning activities (Rio Claro and Bauru), one for industrial emissions (Cubatão) and others from urban sources (São Paulo). The whole campaign provide the equivalent of 30 days of measurements which allowed us to get aerosol optical properties such as backscattering/extinction coefficients, scatter and LIDAR ratios, those were used to correlate with air quality and meteorological indicators and quantities. In this paper we should focus on the preliminary results of the Raman LIDAR system and its derived aerosol optical quantities. © 2010 Copyright SPIE - The International Society for Optical Engineering.

Dry matter yield and nutritional value of Marandu grass under nitrogen fertilization and irrigation in cerrado in São Paulo

The aim of this study was to evaluate dry matter yield and nutritional value of palisade grass (Brachiaria brizantha cv. Marandu) using nitrogen doses and sprinkler irrigation in two periods of the year, aiming at reducing seasonality of forage production. It was used a randomized block design in a split-plot scheme, with five doses of nitrogen (0, 50, 100, 150, and 200 kg/ha/cut), and the sub-plots were defined by the seasons of the year (wet and dry season), with and without irrigation. During the wet season, in the plots with and without irrigation, doses of 175 and 161 kg/ha/cut promoted the highest dry matter yields. During the dry season, 171 kg ha -1N with irrigation resulted in the highest dry matter yield. During the same season, there was no response to N fertilization in the lack of irrigation. Average contents of CP were 10% with and without irrigation. Contents of neutral detergent fiber decreased with nitrogen doses, while acid detergent fiber was not affected by fertilization. Plots under irrigation reached the maximal acid detergent fiber content at N dose of 60 kg ha -1. Irrigation promotes increase of 15% increase in dry matter yield and it increases contents of neutral detergent fiber. © 2010 Sociedade Brasileira de Zootecnia.

Analysis of quality in Brazilian e-commerce (B2C)

The business world has changed the way how people think and act on products and services. In this context, the most recent amendment of the scenarios of retail operations has been the use of technology in sales and distribution. The internet has revolutionized the way people communicate, and moreover as they purchase their goods and services. Thus, the e-commerce, specifically the relation business to customer, or simply B2C, has acted so convincingly in this change of paradigm, namely the purchases in the physical location for the virtual site. Quotes online, ease of payment, price, speed of delivery, have become real order winners of applications for companies that compete in this segment. With the focus on quality of services on e-commerce, the research examines the dimension related to the quality of services, and looks for what of these factors are winners of applications. © 2010 IFIP International Federation for Information Processing.