Efeitos da ligadura do ducto pancreático e da secção ductal com livre drenagem de secreções para o peritônio sobre as funções endócrina e exócrina do pâncreas: estudo clínico e laboratorial em coelhos

As ressecções pancreáticas seguidas de anastomoses acompanham-se de altas taxas de morbidade, que incluem: surtos de pancreatite e, principalmente, fístulas digestivas. Nos transplantes pancreáticos a drenagem da parte exócrina do enxerto para o intestino ou para a bexiga, além das peculiaridades técnicas, também não é isenta de diversas complicações. Visando evitar ou atenuar tais conseqüências e simplificar a técnica cirúrgica, têm sido usadas outras abordagens para o tratamento ductal do coto/enxerto pancreático, tais como: drenagem livre de secreções para o peritônio, com o ducto pancreático aberto, ligadura ductal e oclusão do ducto com polímeros sintéticos. OBJETIVO: O presente estudo visa avaliar clínica e laboratorialmente as funções endócrina e exócrina do pâncreas de coelhos com o ducto aberto e ligado. MÉTODOS: Foram realizadas 150 operações, divididas em 3 grupos: N - manipulação/controle (n=50), A - grupo aberto (n=50), e L - ligado (n=50). Os momentos de observação foram pré-operatório, dia 0 (dia da operação) e pós-operatório (observação e sacrifício): 7 dias, 14 dias, 28 dias, 90 dias e 180 dias. Os parâmetros analisados foram: estado geral, atividade, controles do peso corporal, ingestão hídrica, ingestão alimentar e dosagens da amilase sangüínea, glicemia, glicose urinária e insulina plasmática. RESULTADOS: Todos os grupos tiveram evolução clínica similar, com bom estado geral, ganho ponderal progressivo e valores normais da ingestão hídrica e ingestão alimentar. Exceto uma significativa elevação da amilase sangüínea nas primeiras 24-48h para os 2 grupos com interferência ductal, não houve qualquer alteração dos níveis basais da glicemia, glicosúria e insulinemia entre os 3 grupos experimentais, em todos os momentos de observação. CONCLUSÃO: À exceção da amilase sangüínea, cujos níveis basais foram significativamente elevados no 1º e 2º dias de pós-operatório, as duas modalidades técnicas de abordagem da secreção exócrina do pâncreas, utilizadas em coelhos, não determinaram quaisquer alterações clínicas, bem como dos níveis basais de glicose sangüínea, glicose urinária e insulina plasmática, durante 6 meses de seguimento.

Evolução da paisagem do baixo curso do rio de Piranhas-Assu (1988-2024): uso de autômatos celulares em modelo dinâmico espacial para simulação de cenários futuros

The lower course of Piranhas-Assu river, located in the north coast of Rio Grande do Norte, Brazil, arouses a keen interest as a study field, once it concentrates, besides petroleum and gas exploration, activities related to shrimp culture, salt and horticulture, factors that also deserve special attention. Thus, the awareness of the study field environmental stage demands studies from researchers and discernment from society, as a way of understanding the inter-relation between environment and men. Therefore, this work attempts at understanding and studying the dynamics of land use in the lower course of Piranhas-Assu river, through a multitemporal analysis of present and past, accomplishing future projections through simulation models. The work is divided in stages that include the research, analysis, interpretation of results, and the generation of simulation models, to analyze the landscape tendencies, making possible to identify indicators which cause such changes in the lower course of the river. From Geographical Database, the necessary exploratory analyses were accomplished to the following items: land use evolution, natural and environmental vulnerability, multiple geodiversity indexes, and preparation of the data to be used in the simulation model. Later, the construction of the landscape simulation model was conducted. Sequentially, simulations of future sceneries were accomplished through the execution of the model in a specific software environment. Last, the analyses of landscape tendencies in the study field were carried out. The lower course of Piranhas-Assu River didn't show any intense dynamics in landscape changing, once in the period taken into account (from 1988 to 2004) class stability proved to be superior to its transformations. Activities related to agriculture and livestock are the ones that influence, mostly, the landscape dynamics. The production of sea shrimp and petroleum also infers in the landscape, although in smaller proportion. INCRA s public policies excessively determined the dynamics of the landscape in the lower course of Piranhas-Assu River, RN. In respect to its natural vulnerability, the lower course of Piranhas-Assu River, RN, features more vulnerable than stable areas. The landscape simulation, in the first taken period (2004-2009), indicated considerable increases and decreases of antropic activities, if compared to its sequent periods (2009-2014, 2014-2019 and 2019-2024). The simulation, in a wider analysis, showed that the determining factors for the space mobility of antropic activities, in the focused area, are related to the pre-existence of communities with agricultural capability and to the existence of access routes and drainage. Considering the area that features fixed and mobile dunes, located in Porto do Mangue district, we recommend its conversion into a conservation area

Caracterização geológico-geofísica do meio aqüífero fissural : uma contribuição aos modelos de fluxo e armazenamento de água subterrânea

Northeastern Brazil is mainly formed by crystalline terrains (around 60% in area). Moreover, this region presents a semi-arid climate so that it is periodically subject to drought seasons. Furthermore, ground water quality extracted fromwells usually presents poor quality because of their high salinity contents. Nevertheless, ground water is still a very important source of water for human and animal consumption in this region. Well sitting in hard rocks terrains in Northeastern Brazil offers a mean success index of aboul 60%, given that a successful siting is defined by a well producing at least 0.5 m³/h. This low index reveals lack of knowledga about the true conditions of storage and percolation of ground water in crystalline rocks. Two models for structures storing and producing ground water in crystalline rocks in Northeastem Brazil have been proposed in the literature. The first model,tradnionally used for well sitting since the sixties are controlled by faults or fractures zones. This model is commonly referred, in Brazilian hydrogeological literature, as the "creek-crack" model (riacho-fenda in Portuguese). Sites appearing to present dense drainage network are preferred for water well siting - particularly at points where the drainages cross-cul each other. Field follow up work is usually based only on geological criteria. The second model is the "eluvio-alluvial through" (calha eluvio-aluvionar in Portuguese); it is also described in the literature but it is not yet incorporated in well sitting practice. This model is based on the hypothesis that reclilinear drainages can also be controlled by the folietion of the rock. Eventually, depending upon the degree of weathering, a through-shaped structure filled with sediments (alluvium and regolith) can be developed which can store and water can be produced from. Using severalfield case studies, this Thesis presents a thorough analysis ofthe two above cited models and proposes a new model. The analysis is based on an integrated methodological approach using geophysics and structural geology. Both land (Resitiviy and Ground Penetrating Radar- GPR) and aerogeophysical (magnetics and frequency domain eletromagnetics) surveys were used. Slructural analysis emphasized neolectonic aspects; in general, itwas found that fractures in the E-W direction are relatively open, as compared to fracturas inthe N-S direction, probably because E-W fractures were opened by the neotectonic stress regime in Northeastern Brazil, which is controlled by E-W compression and N-S extension. The riacho-fenda model is valid where drainages are controlled by fractures. The degree of fracturing and associated weathering dictale the hydrogeological potential of the structure. Field work in structural analogues reveals that subvertical fractures show consistent directions both in outcrop and aerophotograph scales. Geophysical surveys reveal subvertical conductive anomalies associated to the fracture network controlling the drainage; one of the borders of the conductive anomaly usually coincide wih the drainage. An aspect of particular importance to the validation of fracture control are the possible presence of relalively deep conductive anomalies wihoul continuation or propagalion to the surface. The conductive nature of lhe anomaly is due to the presence of wealhered rock and sedirnenls (alluvium and/or regolilh) storing ground waler which occur associated to the fracture network. Magnetic surveys are not very sensisnive to these structures.lf soil or covering sedirnents are resislive (> 100 Ohm.m), GPR can ba used to image precisely lhe fracture network. A major limialion of riacho-fenda model, revealed by GPR images, is associated to the fact thal subhorizontal fractures do play a very important role in connecting the fracture network, besides connect shallow recharge zones to relalively deep subvertical frecture zones. Iffractures play just a secondary control on the drainage, however, r/acho-fenda model may have a very limiled validny; in these cases, large portions oflhe drainage do nol coincide wilh frectures and mosl oflhewells localed in lhe drainage surrounding would resull dry. Usually, a secondary conlrol on lhe drainage by Ihefraclure networkcan be revealed only wilh detailed geophysical survey. The calha elClv1o-aluvlonarmodel is valid where drainages are conlrolled by folialion. The degree 01 wealhering 01 lhe lolialion planes dictales lhe hydrogeological polenlial 01 lhe slruclure. Outcrop analysis reveals Ihal lolialion and drainage direclions are parallel and Ihal no Iraclures, orfraclures wilh diflerent directions 01 lhe drainage direclion occur. Geophysical surveys reveal conduclive anomalies in a slab lorm associaled 10 lhe Ihrough 01 lhe wealhered rock and sedimenls (alluvium and/or regolith). Magnelic surveys can ofler a very good conlrol on lolialion direclion. An importanl aspect 10 validale lolialion conlrol are lhe presence 01 conductive anomalies showing shallow and deep portions area which are linked. Illhere is an exlensive soil cover, r/acho-fenda and calha eIClv1o-aluv/onar conlrols can be easily misinlerpreled in lhe absence 01 geophysical conlrol. Certainly, Ihis lacl could explain at leasl a part of lhe failure index in well sitting. The model wealhering sack (bolsllo de Intempertsmo in Portuguese) is proposed to explain cases where a very inlensive wealhering occur over lhe crystalline rock so Ihal a secondary inlerslilial porosity is crealed. The waler is Ihen stored in lhe porous of lhe regolilh in a similar mannerlo sedimentary rocks. A possible example ofthis model was delecled by using land geophysical survey where a relalivelyvery deep isolaled conduclive anomaly, in a slab form, was delected. Iflhis structure does store ground waler, certainly Ihere must be a link 01 lhe deep slructure wilh lhe surface in orderlo provide walerfeeding. This model mighl explain anomalous waler yields as greal as 50 m³/h Ihalsomelimescan occur in crystalline rocks in Northeaslern Brazil

Tratamento de linfocele inguinal pós-operatória com injeção de cola de fibrina: relato de caso

O paciente desenvolveu linforragia na região inguinal direita, depois de ponte aorto-bifemoral com enxerto de dácron®. Não respondeu ao tratamento conservador com cuidados locais e compressão. Foi realizado exame de ultra-sonografia Doppler, que evidenciou grande linfocele (6,4 x 3,36 x 6,1 cm), tratada pelo esvaziamento da loja por aspiração e injeção de cola de fibrina (1,6 mL) em seu interior. O paciente se recuperou sem intercorrências e sem recidiva, após 3 meses de seguimento.

Geomorfologia e neotectônica no Vale do Apodi-Mossoró RN

Numerous studies have indicated that the Potiguar Basin is affected by Cenozoic tectonics. The reactivation of Cretaceous fault systems affect the post-rift units, witch include Neogene and overlying Quaternary sediments. In this context, the objectives of this thesis are the followings: (1) to characterize the effects of post-rift tectonics in the morphology of Apodi Mossoró-river valley located in the central portion of the Potiguar, (2) to characterize the drainage of the Apodi Mossoró river valley and investigate the behavior of their channels across active faults, and (3) to propose a geologic-geomorphological evolutionary model for the study area. This study used a geological and geomorphological mapping of the central part of the basin, with emphasis on the Quaternary record, luminescence dating of sediments, and geoelectric profiles of the area. The results reveal by maps of structural lineaments and drainage channels of the rivers form valleys that are affected by faults and folds. In Apodi-Mossoró valley, anomalies of channel morphology are associated with the deformation of the post-rift basin. These anomalies show the reactivation of major fault systems in the Potiguar Basin in Cenozoic. On a regional scale, can be seen through the vertical electric profiles that the Cenozoic tectonics is responsible for the elevation of a macro dome NE-SE-trending 70-km long and 50km wide and up to 270 above sea level. In this sector, the vertical electric profiles data show that the contact between the Cretaceous and Neogene rise more than 100m. This Is an important feature of inversion data obtained in this work showed that the deposits that cover the macro dome (Serra do Mel) have ages of 119 ka to 43 ka. In the river valley and surrounding areas Apodi-Mossoró ages vary between 319 ka and 2.7 ka. From these data it was possible to establish the correct geochronological posiconamento paleodepósitos of distinguishing them from the fluvial deposits of the Neogene (Barreiras Formation)

Timoma em cão. Relato de caso

Uma cadela, Dachshund, quatro anos, foi encaminhada ao H.V. da FMVZ-UNESP-Botucatu-SP com histórico de prostração, emagrecimento progressivo, anorexia, cansaço e tosse seca. Ao exame clínico observou-se apatia, secreção nasal serosa bilateral e dispnéia intensa. Radiografia torácica demonstrou efusão pleural, edema pulmonar acentuado, desvio dorsal da traquéia e possível massa mediastinal. A ultra-sonografia, após drenagem torácica, confirmou a presença de massa mediastinal, sendo classificada como neoplasia maligna de origem epitelial pela citologia aspirativa por agulha fina. O animal veio a óbito logo após o diagnóstico de neoplasia. À necropsia constatou-se massa mediastinal encapsulada, consistência macia e superfície de corte com coloração branco-acinzentada e áreas necrótico-hemorrágicas, localizada na região ântero-ventral do tórax. O exame histopatológico demonstrou células epiteliais neoplásicas, células linfóides (timócitos) com morfologia normal, vasos sangüíneos de pequeno e médio calibre, formações císticas com conteúdo eosinofílico e corpúsculos de Hassall. A imunohistoquímica apresentou positividade para citoqueratina AE1/AE3 e UCHL, confirmando o diagnóstico de timoma.

Implicações tectônicas na hidrologia do aqüífero Barreiras e sistema lacustre do Bonfim, Nísia Floresta-RN

This MSc dissertation presents the results of a research carried out in a 500 km2 area in the Nísia Floresta county. The main goal of the research was to evaluate fault influence on hidrology features of aquifers and lakes, mainly in the Barreiras Group and in the Bonfim lake cluster respectively. The Precambrian crystalline basement is made of Caicó Complex rocks. They are capped by cretaceous sedimentary rocks and by cenozoic sedimentary rocks. Only the latter outcrop in the study area, wheareas the former are described in boreholes. Faults cut across all stratigraphic units and their main trends are NW, NE and E-W, which have been generated by E-W compression. Subordinate N-S trending faults also take place and have been generated by N-S oriented compression. Fault controlled hydrologic features are observed throughout the study area. There are sudden changes in saturated thicknesses of the Barreiras Aquifer due to vertical displacement of the Barreiras Group. The most important underground water source of the Bonfim Lake is related to abrupt thickness changes of the aquifer. In addition, the main faults control the underground drainage network and, probably, change in direction of equipotential surfaces seen on the potenciometric map. Regarding the surface hydrologic features, faults also control river and stream channels, as well as lake origin and shapes. The Bonfim Lake, in particular, has its peculiar shape, which follows NW and NE lineaments, and origin related to faulting and probably underground carstics processes

Aspectos Morfo-Dinâmicos daComplexo Lagunar Nísia Floresta-Papeba-Guaraíras, Região Costeira Sul Oriental Do RN

This dissertation presents the results of research developed in the Nísia Floresta-Papeba-Guaraíras Lagoon Complex, located on the south coast of the Rio Grande do Norte State. The main objectives of this dissertation were the stratrigraphic characterization, in detail scale, of the and the coastal dynamics study of the lagoonal deposits sedimentation, as well as the morpho-dynamic analysis of the area. Therefore, an interdisciplinary methodology was adopted, in which all sedimentological, morpho-tectonic and geomorphological data were integrated. Vibracore up to 4m in length were carried out in the lagoons. The referred lagoon complex made of a system of three lagoons that interact through two artificial channels, named Boqueirão and Surubajá. The Guaraíras lagoon, the largest one in the system, corresponds to the estuary zone of the Trairi and Jacu rivers. The sedimentary load brought by these rivers is strongly reworked by tide currents, forming an important net-work of channels and sandy bars inside this lagoon and close to its channel connection with the sea. The stratigraphic units of the area are Cenozoic in age, and are represented by sedimentary rocks of the Barreiras Formation (sandstones, mudstones and conglomerates) and by rocks beach, as well as by siliciclastics sediments related with the fluvial dynamics of tide plain (clay and sandy bars), and coast (sand dunes and beaches). Among the recognized geomorphologic aspects, there are the elements associated with continental enviroments (drainage basins of the Trairi, Baldum and Jacu rivers, coastal tableland supported by the Barreiras Formation), and transitional environments (lagoon complex, dune fields, cliffs, tidal channels and beach rocks lines). The morphotectonic analysis indicates that fauts affect Barreiras Formation sedimentary rocks, with two sets of main lineaments: SW-NE and SE-NW. The anomalies in the drainage net are directly associated with these fault/fracture system, which control and subdivede the low courses of the Trairi and Jacu rivers, at least a tail of their flowing principal courses. The Nísia Floresta, Papeba and Guaraíras lagoons present strong morphological control according to the lineament directions. Taking into account the lagoonal deposits, the sedimentological analyses reflect a sediment distribution related to the interaction of the fluvial and sea processes that act in the study area. The correlated deposits show textural mainly microclastic characteristics of shallow waters, and of currents of low to moderate energy.In general, the Nísia Floresta-Papeba-Guaraíras lagoon Complex, constitutes a very intrinsec group, that undewent important changes in historical times that are reflected in the currents clays. Inaddition to the natural processes that act in this system, we should take into account the antrohopic intervention, which have increased in the past years

Aspectos morfo-tectônicos nos platôs de Portalegre, Martins e Santana/RN

A morpho-structural analysis was performed in the uplifted siliciclastic deposits of the Serra do Martins Formation along the Portalegre, Martins and Santana plateaux, in the southeastern and central regions of Rio Grande do Norte State. Due to the lack of biostratigraphic records, this formation has a disputable age.The adopted approach was based on the analysis of the drainage patterns and in the recognition of topographic surfaces and regional structures, subjected to neotectonic deformation and rejuvenation the present stress field. These events are recorded in the lineament arrays and as anomalous features of the landscape, such as the uplifted plateaux.The morpho-sculptural evolution of the studied blocks is expressed as erosive and accumulative processes. The former ones include erosional scarpments, cuestas and amphitheaters as the most characteristic features, while debris slopes represent acumulative examples. Such elements attest to the recent disequilibrium of the plateaux, and the absence of well developed alluvium terraces suggest an accelerated uplift process. The directions of the linear features observed in remote sensing products evidence the control of the basement structural trends, inherited from the pre-Cenozoic evolution. The NNE-SSW direction controls the main erosional features of the plateaux, while the N-S direction is a major drainage control, being also recognized in the Potiguar Basin. An E-W trend occurs as a less developed direction, reflecting either a system of mesozoic basic dykes or precambrian brittle structures. As regards to the drainage arrays, an arborescent, varying to a roughly N-S rectangular pattern, was identified in the Portalegre-Martins block. The Santana plateau displays rectilinear (northern border) and dendritic arborescent (southern border) patterns. In the sedimentary cover, the drainage pattern varies from rectangular to angular, reflecting inheritance from the crystaline basement. The most significative directions, N, NE and NW, mark the erosional fronts of the plateaux. Drainage anomalies, characterized by elbows or paralell confluencies, reinforce the arguments mentioned above. The data sets evidence the relationships between endogenous (lithology, structures) and exogenous features as the main controls of terrain dissecation, associated to vertical (epirogenesis) movements and horizontal tectonics. A final discussion addresses the relationships of the Serra do Martins Formation with the sedimentary record of Potiguar Basin, trying to establish chronostratigraphic links with the main evolutionary steps of this part of the Borborema Province, and possible mechanisms involved in the uplift of the plateaux and other stratigraphic units in the region

Estruturas de acumulação de água subterrânea em rochas cristalinas: estudo geofísico e geológico de casos no Estado do Rio Grande do Norte

Geological and geophysical studies (resistivity, self potential and VLF) were undertaken in the Tararaca and Santa Rita farms, respectively close to the Santo Antônio and Santa Cruz villages, eastern Rio Grande do Norte State, NE Brazil. Their aim was to characterize water acummulation structures in crystalline rocks. Based on geological and geophysical data, two models were characterized, the fracture-stream and the eluvio-alluvial through, in part already described in the literature. In the Tararaca Farm, a water well was located in a NW-trending streamlet; surrounding outcrops display fractures with the same orientation. Apparent resistivity sections, accross the stream channel, confirm fracturing at depth. The VLF profiles systematically display an alignment of equivalent current density anomalies, coinciding with the stream. Based on such data, the classical fracture-stream model seems to be well characterized at this place. In the Santa Rita Farm, a NE-trending stream display a metric-thick eluvioregolith-alluvial cover. The outcropping bedrock do not present fractures paralell to the stream direction, although the latter coincides with the trend of the gneiss foliation, which dips to the south. Geophysical data confirm the absence of a fracture zone at this place, but delineate the borders of a through-shaped structure filled with sediments (alluvium and regolith). The southern border of this structure dips steeper compared to the northern one. This water acummulation structure corresponds to an alternative model as regards to the classical fracture-stream, being named as the eluvio-alluvial trough. Its local controls are the drainage and relief, coupled with the bedrock weathering preferentially following foliation planes, generating the asymmetry of the through

Correlação entre contexto morfoestrutural e sismicidade nas regiões de João Câmara e São Rafael (RN)

This MSc thesis describes brittle deformation in two seismic zones located in north-eastern Brazil: João Câmara and São Rafael, Rio Grande do Norte State. Both areas show seismogenic faults, Samambaia and São Rafael, indicated by narrow zones of epicentres with a strike of 040o, a lenght of 30 km and 4 km, and a depth of 1-12 and 0,5-4 km, respectively. The first seismological and geological studies suggested blind faults or faults that were still in the beginning of the nucleation process. The region is under E-W-oriented compression and is underlain by Precambrian terrains, deformed by one or more orogenic cycles, which generated shear zones generally marked by strong pervasive foliation and sigmoidal shapes. The crystalline basement is capped by the Cretaceous Potiguar basin, which is also locally capped by Pliocene continental siliciclastic deposits (Barreiras Formation), and Quaternary alluvium. The main aim of this study was to map epicentral areas and find whether there are any surface geological or morphotectonic expression related to the seismogenic faults. A detailed geological map was carried out in both seismic areas in order to identify brittle structures and fault-related drainage/topographic features. Geological and morphotectonic evidence indicate that both seismogenic faults take place along dormant structures. They either cut Cenozoic rocks or show topographic expression, i.e., are related to topographic heights or depressions and straight river channels. Faults rocks in the Samambaia and São Rafael faults are cataclasite, fault breccia, fault gouge, pseudotachylyte, and quartz veins, which point to reactivation processes in different crustal levels. The age of the first Samambaia and the São Rafael faulting movement possibly ranges from late Precambrian to late Cretaceous. Both fault cut across Precambrian fabric. They also show evidence of brittle processes which took place between 4 and 12 km deep, which probably have not occurred in Cenozoic times. The findings are of great importance for regional seismic hazard. They indicate that fault zones are longer than previously suggested by seismogenic studies. According to the results, the methodology used during this thesis may also be useful in other neotectonic investigation in intraplate areas

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

Lacrimal excretory system sequelae in patients treated for leishmaniasis

A leishmaniose pode destruir os tecidos nasais resultando em alterações da via lacrimal excretora. OBJETIVO: Avaliar a ocorrência de alterações do sistema lacrimal excretor em portadores de leishmaniose na fase de pós-tratamento. MÉTODOS: Foi realizada a avaliação da via lacrimal excretora em 45 portadores de leishmaniose tratada (90 vias lacrimais) pelo teste de Jones I. Treze pacientes (26 ductos nasolacrimais) tiveram o teste de Jones I alterado, tendo sido submetidos a dacriocistografia e endoscopia nasal. RESULTADOS: A maioria dos indivíduos avaliados apresentava a leishmaniose na forma cutânea (64,4%). Entretanto, 69,23% dos indivíduos com alteração do sistema lacrimal excretor apresentavam a forma mucocutânea antes do tratamento. A alteração mais freqüentemente detectada foi ducto nasolacrimal permeável e dilatado (92,30%). Apenas 3,84% (1/26) das vias lacrimais estavam obstruídas. A endoscopia nasal mostrou hipertrofia de corneto (53,84%), desvio de septo (53,84%) e perfuração do septo nasal (23,07%). CONCLUSÃO: em portadores de leishmaniose tratada encontra-se como seqüela mais freqüente no sistema excretor lacrimal as vias lacrimais permeáveis e dilatadas.

Dacriocistografia na propedêutica da via lacrimal excretora de adultos

OBJETIVO: Avaliar os achados dacriocistográficos em indivíduos suspeitos de obstrução de vias lacrimais excretoras. MÉTODOS: O estudo foi retrospectivo, tendo sido avaliadas as dacriocistografias de 100 indivíduos adultos, suspeitos de obstrução nasolacrimal, atendidos na Faculdade de Medicina de Botucatu - UNESP. Os dados obtidos foram submetidos à análise estatística descritiva e teste do qui-quadrado. RESULTADOS: A maioria dos pacientes era do sexo feminino e maiores de 60 anos, apresentando obstrução baixa, localizada no seio de Arlt, com saco lacrimal graus 2 ou 3. Vias lacrimais pérvias, com e sem dilatação, também foram encontradas, assim como alterações nasais, como hipertrofia de cornetos. CONCLUSÃO: A dacriocistografia foi importante para diagnosticar o local da obstrução, o grau de dilatação das vias lacrimais, assim como as alterações de estruturas vizinhas. Estas informações sem dúvida são úteis para o planejamento cirúrgico e como indício prognóstico.

Massa paranasal: dacrioestenose congênita? Relato de caso

O objetivo deste é descrever uma criança portadora de massa paranasal, atentando para a importância dos diagnósticos diferenciais. RELATO do CASO: ACS, 6 meses, sexo feminino, desde o nascimento apresentando abaulamento não inflamatório, no canto medial do olho esquerdo, lacrimejamento e hiperemia no olho direito. Ao exame apresentava fenômeno de Bell negativo bilateral, lagoftalmo à direita, ulceração e opacidade corneana à direita; presença de lesão arredondada, de superfície lisa no canto medial do olho esquerdo, sem sinais inflamatórios, medindo aproximadamente 2 cm de diâmetro, não pulsátil. À palpação, a lesão era elevada, de consistência fibroelástica, imóvel, indolor, irredutível. À propedêutica das vias lacrimais, não havia refluxo à compressão, o teste de Milder foi negativo em ambos olhos e as vias apresentavam-se pérvias à dacriocistografia. O exame tomográfico revelou tratar-se de meningocele fronto-etmoidal. COMENTÁRIOS: Os autores chamam a atenção para a adequada semiologia para a investigação das massas paranasais, a fim de se instituir o adequado tratamento.