Litíase intrahepática primária. Relato de caso e revisão da literatura.

Primary intrahepatic lithiasis is an entity defined by intrahepatic stones exclusively located in the IH ducts above the emergence of the common bile duct. The disease is classified in two types: Eastern type (stones formed primarily in intrahepatic ducts; frequent in Japan) and Western type (stones formed in the extrahepatic bile system, usually in gallbladder, which migrate up to the intra-hepatic ducts). The mechanisms of lithogenesis in the entity are as yet not fully understood; multiple factors seem to operate synergistically: anatomical changes of the intrahepatic ducts, metabolic disorders, infections, idiopathic alteration. All these factors may facilitate biliary stasis leading ultimately to stone formation. We report on a case of and review the literature on primary intrahepatic lithiasis, which is a rare occurrence in the West and a disease of difficult surgical approach and high mortality.

Uso e conservação de Piper cernuum Vell. (Piperaceae) na Mata Atlântica: I. Fenologia reprodutiva e dispersão de sementes

The pariparoba (Piper cernuum Vell.), a native plant from the Atlantic Tropical Forest (ATF), has been commonly used in folk medicine. Works seeking the exploitation of P. cernuum natural populations need to be accomplished, seeking compatibility in obtaining income rates and preservation of ATF. The present work aimed to study the reproductive phenology and seed dispersal in P. cernuum natural population in the counties of Sete Barras/SP (Parque Estadual Intervales - PEI). The population of P. cernuum studied in PEI presented continuously bud-inflorescences, green-infrutescences and bud-inflorescence emission, with variation among individuals. Fruit-set average was of 9.1%, varying among individuals. Shading and foliar damage presented negative effect on the fruit-set. Three species of bats were identified as potential dispersors of the P. cernuum seeds: Carollia perspicillata, Anoura geoffroyi and Artibeus sp. The foragement strategy observed was the withdrawal of some seeds per infrutescence per flight. This strategy increases the potential in establishing new plants as well as in increase the potential of gene flow in comparison with the entire infrutescence plant eaten at the night perches. In consequence, the results of reproductive phenology and seed dispersal ecology presented in this work can help to establish management and conservation strategies of P. cernuum natural populations in the ATF.

Características anatômicas de espinheira-santa (Maytenus ilicifolia Mart. ex Reissek e Maytenus aquifolia Mart.) e mata-olho (Sorocea bonplandii (Baill.) Burg. Lanj. & Boer.) para o controle de qualidade da matéria prima

Maytenus ilicifolia and Maytenus aquifolia (Celastraceae) both designated espinheira-santa have proven anti-ulcer activity. Morphologic similarities between leaves of espinheira-santa and mata-olho (Sorocea bonplandii), has motivated fakes in the market of phytotherapy. The present work consisted of the anatomical study, including stem and leaf, of the species M. ilicifolia, M. aquifolia and S. bomplandii. Samples of adult leaves and stem of plants located in the cities of Maringá and Marialva were collected. Both are located in the northwest region of Paraná State. The botanical material was prepared with using usual techniques of anatomy. The leaves of both Maytenus species presented great similarities, characterizing itself for the presence of epidermal cells with straight walls, biseriate palisade tissue, petiole vascular system represented by unique amphicribal bundle and sclereids, which were present in the stems of these two species. S. bomplandii leaves differed of Maytenus species for presenting epidermal cells with undulated walls, uniserite palisade tissue, petiole vascular system represented by many collateral bundles and gelatinous fibres. Non-glandular trichomes, glandular trichomes, and laticifer only occur in S. bomplandii.

Interações entre aves frugívoras e plantas em um fragmento de mata atlântica de Minas Gerais

We studied the frugivorous birds and their fruiting plants during two years in a forest fragment in Viçosa, Minas Gerais State, Brazil. Our aim was to identify the importance of birds and plants based on an importance index that comprise both the number of interactions and interaction exclusiveness. Twentynine bird species and 25 plant species were recorded. Small birds (< 100 g) comprised 85% of the interactions, and Chiroxiphia caudata reached the largest importance index (0.296), with 12 interactions, being six exclusive. Among plants, the melastome Miconia cinnamomifolia reached the largest importance index (0.277), interacting with 72.4% (21) of the bird species. This study showed that seed dispersal by small birds couldn't be underestimated because they disperse seeds of many plant species, even in pristine forests. Studies like this are also important to list the main food resources to frugivorous birds that could be used in management plans.

Levantamento florístico em remanescente de floresta ripária no alto rio Paraná: Mata do Araldo, Porto Rico, Paraná, Brasil

The purpose of this study was to realize a floristic survey in riparian forest remains of the Upper Paraná River, under domain of the submontane seasonal semideciduous forest, located in Porto Rico, Paraná, Brazil (53°19'3 W e 22°47'37 S). Within and in the neighborhood of 10.000 m2 area (100 m × 100 m), 165 species were surveyed, in 124 genera and 60 families, distributed in arboreous, shrubs, herbs, climbers and hemiparasites. Leguminosae, Myrtaceae, Poaceae, Rubiaceae, and Bignoniaceae were the families with the highest species' richness, showing together 33.33%, and the genera more representative were Eugenia, Casearia, Guarea, Inga, Panicum, and Solanum, with 12.73% of the species. Though the perturbations verified in the forest remains, eight species were rare for this type of vegetation and 12 were listed as fishes natural food.

Eficácia e segurança da atorvastatina no tratamento de pacientes com hipercolesterolemia primária

Introduction: Hypercholesterolemia is an important risk factor for cardiovascular disease, the first cause of death and third reason for hospital admissions in Brazil. The reduction of serum cholesterol levels reduces morbidity and mortality from cardiovascular disease. The present study evaluated the efficacy and safety of atorvastatin in the treatment of Brazilian patients with primary hypercholesterolemia (types IIA and IIB dyslipidemias). Patients and methods: After a 4-week wash-out period, 152 patients were treated with atorvastatin at the initial dose of 10 mg/day. According to treatment efficacy within the first 8 weeks this dose could be increased to 20 mg/day. Treatment lasted for a total of 16 weeks, and its efficacy was evaluated by the reduction of serum levels of LDL-cholesterol, total cholesterol, HDL-cholesterol, and triglycerides, as well as by the propotion of patients that achieved the target levels recommended by the National Cholesterol Education Program - Adult Treatment Panel II (NCEP ATP II) Results: The analysis of efficacy was conducted in 145 patients. Atorvastatin led to significant reductions in the levels of LDL-cholesterol after 8 and 16 weeks of treatment (P<0.001 for both comparisons). The relative reduction of such levels was 38% (P<0.001 after 8 and 16 weeks). Atorvastatin also led to significant reductions of total cholesterol and triglycerides. At the end of the study, 81% of patients achieved the target LDL-cholesterol levels recommended by NCEP ATP II. Treatment was well tolerated, and was interrupted due to creatine phosphokinase elevation in only one patient. Conclusion: Atorvastatina is efficacious and safe in the treatment of patients with primary hypercholesteromia. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Relação peso-comprimento e fator de condição de Brycon opalinus (Pisces, Characiformes) no Parque Estadual da Serra do Mar-Núcleo Santa Virgínia, Mata Atlântica, Estado de São Paulo, Brasil

In this study, the length-weight relationship and the condition factor of Brycon opalinus were analyzed in three rivers within the Santa Virgínia Unit, at Serra do Mar State Park, in São Paulo State. The different conditions in these three environments were evidenced, such as the seasonality, reproductive period, and the differences between females and males according to the parameters which evidenced the best physiological condition of the fish. In this species, the condition factor varied along the seasons at all three collection sites. The length of the first gonadal maturation and the reproductive period were long, with the highest intensity in the spring and summer.

Conhecimento popular sobre plantas medicinais em comunidades rurais de mata atlântica - Itacaré, BA, Brasil

This study's goal was to caryy out an ethnobotanical survey focusing on the knowledge and use of medicinal plants within two rural communities (Marambaia and Camboinha), which are situated in an Environmental Protection Area in Atlantic Forest of Southern Bahia, Brazil. These communities use medicinal plants as an important therapeutic activity, which permits the rural inhabitants to be self-sufficient regarding health care. Data were collected through interviews with 26 families (24% of the total). The medicinal plants collected (98 species) were catalogued, identified and deposited at the Herbarium Rio Clarense (HRCB). They belong to 40 families so that Lamiaceae was the most cited. The majority of these species (78%) are cultivated, usually in backyards by local inhabitants. The leaf is the most common part of the plant used in medicinal preparations. The species with the greatest number of citations were Chenopodium ambrosioides L. and Lippia alba (Mill) N.E. Br. These species are also associated with the highest number of therapeutic uses. Use agreement and diversity index from this survey were compared to other surveys conducted in Brazilian Tropical Forests.

Avaliação da resposta à quimioterapia primária em amostra de mulheres brasileiras com tumores de mama localmente avançados

PURPOSE: to evaluate the loco-regional response to primary chemotherapy in patients with breast cancer at stages II and III. METHODS: a retrospective and analytical clinical study carried out in 97 patients with an average age of 52.2 years old, with breast cancer at stages II and III, attended from January 1993 to December 2004, and submitted to 3 to 4 cycles of primary chemotherapy with 5-fl uorouracil - 500 mg/m2, epirubicin - 50 mg/m2 and cyclophosphamide - 500 mg/m2 or doxorubicin - 50 mg/m2 e cyclophosphamide - 500 mg/m2, and then to loco-regional surgical conservative or radical surgical treatment. Chi-square and Fisher's exact tests were used to study the association among the variables (age, menopausal state, pre-chemotherapy tumoral volume, axillary condition, stage, therapeutic scheme and number of cycles), while Pearson's correlation coefficient was used for the quantitative variables (tumoral volume according to the anatomo-pathological study and the post-chemotherapy clinical tumoral volume. The significance level was 5%. RESULTS: there were 56.8% of cases at stage II and 43.2% at stage III. Approximately 50% of the patients received FEC50 and 50% AC. Objective clinical response with primary chemotherapy was obtained in 64.9% of the cases. Full clinical response occurred in 12.3% of patients, while full pathological response occurred in 10.3% of the cases. CONCLUSIONS: there was a statistically significant correlation between the number of cycles and the response to primary chemotherapy. Patients who received 4 cycles had better response than those who received 3 cycles. There was also a statistically significant concordance between the evaluation through clinical examination of the response to primary chemotherapy and the pathological findings. No statistically significant correlation was observed concerning age, menopausal status, tumoral volume, and pretreatment of axillary damage.

Sinalização visual e biologia reprodutiva de Dendropsophus werneri (Anura: Hylidae) em área de Mata Atlântica no estado do Paraná, Brasil

We studied the reproductive biology and visual signaling of Dendropsophus werneri, whose distribution is limited to the Atlantic Rain Forest. The fieldwork was carried out in the Estação 2 do IAPAR, municipality of Morretes, state of Paraná, Brazil, from August 2006 to March 2007. Additional information on reproduction was gathered in the Reserva Natural Salto Morato, municipality of Guaraqueçaba, state of Paraná, Brazil, from September 2006 to March 2007. Males were smaller than females. Males called throughout all the study period in Morretes, but were active only during three months in Guaraqueçaba; males called from low vegetation along the edge of temporary ponds in open areas. The visual signaling was observed in two contexts: (1) aggressive behaviors between two males and (2) during the reproduction, by amplectant males. In the territorial behavior, males exhibited both aggressive and mixed calls, visual signaling as well as physical combats. We also recorded satellite behavior in four males. The mean egg number per clutch was 244 ± 32 eggs, varying between 188 and 310 eggs. We observed two reproductive modes: Mode 1 and Mode 24. In the present study, Dendropsophus werneri showed elaborated social interactions involving visual signaling, territorial behavior, mating bahavior with tactile stimuli, and two different reproductive modes, demonstrating its complex reproductive biology.

Regeneração natural de espécies da Mata Atlǎntica em sub-bosque de Eucalyptus saligna Smith. em uma antiga unidade de produção forestal no Parque das Neblinas, Bertioga, SP

This study aimed at characterizing the potential for natural regeneration of native vegetation in the under-story of an earlier Eucalyptus saligna Smith production stand. The study was carried out at the Parque das Neblinas, Bertioga municipality, SP, in a 45 ha third rotation stand; which had been abandoned 15 years ago for natural regeneration to occur. The sampling was done in 24 plots of 20 × 40 m. The sampled area was of 19,200 m2, with inventory made of 100% of the eucalyptus trees. All regeneration trees with a height ≥ 1.30 m and DBH ≥ 5.0 cm were measured, as well as adult individuals with DBH ≥ 5.0 cm; surveyed in two size classes. 1,417 individuals of E. saligna were measured, with a density of 738,02 individuals/ha and a basal area of 22.69 m2/ha. Among 2,763 natural regeneration individuals, 111 species belonged to 66 genera and 34 botanical families. The species represented 43.7% of the tree richness of neighboring native forest fragments. The total estimated density and the basal area were respectively 1,052.6 individuals/ha and 6.4 m2/ha of autochthonous trees with DBH ≥ 5.0 cm (Class 1); while for regeneration there were 3,864.58 individuals/ha, and 2.76 m2/ha of individuals with a height ≥ 1.30 m and DBH < 5.0 cm (Class 2). Shannon diversity (H') was 2.83 and 3.68, respectively, for Classes 1 and 2, and the corrected species richness for a 1000-individual sample (R1000) were 75.6 and 87.29 (Fisher's a index) for the same classes. The majority of the species (34.84%) was typical from the understory of wet tropical forest and had zoochoric fruit dispersal (67.57%). The results indicate that, under these conditions, a eucalyptus forest is able to provide adequate regeneration niches for native vegetation, and may represent a sink habitat for local populations.

Estudo de caso: o mercado de terras rurais na região da zona da mata de Pernambuco, Brasil

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Aplicação de técnica de geoprocessamento em áreas degradadas de mata ciliar e sua correlação com qualidade da água numa subbacia hidrográfica

Studying the physical environment of a watershed is the basic condition for a successful planning of the riparian forest preservation, and for water production and conservation. The aims of the present study were to analyze and quantify the spatial and temporal evolution (1984 and 2010) using Landsat-5 satellite images of Cintra Stream sub-watershed, Botucatu, São Paulo State, Brazil, processed by the software IDRISI Andes, as well as to analyze the water quality through the parameters pH, EC, DO and BOD5 at 4 different sites in the years 1999, 2008 and 2009. Considering the 1076.48ha area of the sub-watershed, the pasture class of 1984 was reduced by 25.55% in 2010, resulting in an increase in the remaining classes. The most important class was native forest and reforestation since it had an increase of 5.08%, which indicates recovery of the riparian forest. Degraded areas were identified close to the inferior limit of the sub-watershed (P3 and P4), as well as local contamination (P1 and P2) with worsening of the water quality in the remaining sites in the periods 2008 and 2009. Recovery and management of the ecological succession of degraded areas and water quality monitoring at 1 and 2 sites will be necessary to reestablish the natural condition of the area studied.

(Em defesa dos) Cuidados Paliativos na Atenção Primária à Saúde

One of the basic principles of the Brazilian Public Health System (SUS) is integral assistance, which considers the integrality of the individual, of service and care, which should necessarily include end of life care. Our aim was to analyze the work process of health professionals at the Family Health Strategy / Primary Care that already cared for people in the dying process to propose viable contributions to the Public Health area as regards the implementation of Palliative Care in Primary Care. We present data referring to the following themes: Singular Therapeutic Project (PTS); death quality as PTS goal (work purpose); the team's ways of doing (bonding as a pact condition). Eleven health professionals (four nurses and seven physicians) linked to the Family Health Strategy (ESF) of Campinas (São Paulo) participated on this research. From the interviews, data analysis followed the Socio-Historical Psychology theoretical and methodological approach. The professionals' activity was analyzed in articulation with the specificities of caring for people in the dying process. We found that action planning in health is oriented by the Singular Therapeutic Project (PTS), with an emphasis in social diagnosis and the need of a bond for attaining a pact. It is understood that the purpose of health professionals' activity is to promote dignity and life quality in the dying process, but integral care should include not only individual and family care, but also the defence of full human development during all phases of life.

Diversidade e distribuição dos lagartos de uma área de ecótono entre Cerrado e Mata Atlântica, no sudeste do Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)