Efeitos do uso da adrenalina na anestesia local odontológica em portador de coronariopatia

FUNDAMENTO: A literatura é controversa no que se refere ao uso de vasoconstritores para anestesia local em cardiopatas, havendo preocupação com a indução de descompensação cardíaca. OBJETIVO: Avaliar parâmetros eletrocardiográficos e de pressão arterial durante procedimento odontológico restaurador sob anestesia local com e sem vasoconstritor em portadores de doença arterial coronária. MÉTODOS: Neste estudo foram avaliados 62 pacientes. As idades variaram de 39 a 80 anos (média de 58,7 + 8,8) anos, sendo 51 pacientes (82,3%) do sexo masculino. Do total de pacientes, 30 foram randomizados para receber anestesia com lidocaína 2% com adrenalina (grupo LCA) e os demais para lidocaína 2% sem vasoconstritor (grupo LSA). Todos foram submetidos a monitorização ambulatorial da pressão arterial e eletrocardiografia dinâmica por 24 horas. Foram considerados três períodos: 1) basal (registros obtidos durante os 60 minutos que antecederam o procedimento); 2) procedimento (registros obtidos desde o início da anestesia até o final do procedimento) e 3) das 24 horas. RESULTADOS: Houve elevação da pressão arterial do período basal para o procedimento nos dois grupos quando analisados separadamente; quando confrontados, não apresentaram diferença entre si. A freqüência cardíaca não se alterou nos dois grupos. Depressão do segmento ST > 1 mm não ocorreu durante os períodos basal e procedimento. Arritmias em número superior a 10 por hora estiveram presentes durante o procedimento em sete pacientes (12,5%), sendo quatro (13,8%) do grupo que recebeu anestesia sem adrenalina e três (11,1%) do grupo com adrenalina. CONCLUSÃO: Não houve diferença em relação a comportamento da pressão arterial, freqüência cardíaca, evidência de isquemia e arritmias entre os grupos. O uso de vasoconstritor mostrou-se seguro dentro dos limites do estudo.

The use of forensic polycyclic aromatic hydrocarbon signatures and Compound Ratio Analysis Techniques (CORAT) for the source characterisation of petrogenic/pyrogenic environmental releases.

This study utilised recent developments in forensic aromatic hydrocarbon fingerprint analysis to characterise and identify specific biogenic, pyrogenic and petrogenic contamination. The fingerprinting and data interpretation techniques discussed include the recognition of: The distribution patterns of hydrocarbons (alkylated naphthalene, phenanthrene, dibenzothiophene, fluorene, chrysene and phenol isomers), • Analysis of “source-specific marker” compounds (individual saturated hydrocarbons, including n-alkanes (n-C5 through 0-C40) • Selected benzene, toluene, ethylbenzene and xylene isomers (BTEX), • The recalcitrant isoprenoids; pristane and phytane and • The determination of diagnostic ratios of specific petroleum / non-petroleum constituents, and the application of various statistical and numerical analysis tools. An unknown sample from the Irish Environmental Protection Agency (EPA) for origin characterisation was subjected to analysis by gas chromatography utilising both flame ionisation and mass spectral detection techniques in comparison to known reference materials. The percentage of the individual Polycyclic Aromatic Hydrocarbons (PAIIs) and biomarker concentrations in the unknown sample were normalised to the sum of the analytes and the results were compared with the corresponding results with a range of reference materials. In addition, to the determination of conventional diagnostic PAH and biomarker ratios, a number of “source-specific markers” isomeric PAHs within the same alkylation levels were determined, and their relative abundance ratios were computed in order to definitively identify and differentiate the various sources. Statistical logarithmic star plots were generated from both sets of data to give a pictorial representation of the comparison between the unknown sample and reference products. The study successfully characterised the unknown sample as being contaminated with a “coal tar” and clearly demonstrates the future role of compound ratio analysis (CORAT) in the identification of possible source contaminants.

Observações sôbre alguns diplópodos de interêsse agrícola

This paper deals with some Millipedes (Diplopoda), which have been verified associated with or attacking on cultivated plants. The following forms are reported: 1) Orthomorpha (Orthomorpha) coarctata (Saussure, 1860) - Enormous numbers of individuals belonging to this species, whose synanthropic habits are frequentely emphasized, were collected around coffee-plants kept in a nursery. Young plants (with 10 cm) are mentioned as damaged by the species, which gnaws the stem, just above the roots. The dusting with benzene hexachloride (BHC) was successfully employed to prevent the invasions. Other occurrences of O. coarctata are reported, ecological and biological informations being also added. 2) Orthomorpha (Kalorthomorpha) gracilis (C. L. Koch, 1847) - Observed frequentely associated with the former species, being however less numerous. Both forms are very active, seemming to be widely distributed throughout the State of S. Paulo. 3) Cylindroiulus (Aneuloboiulus) britannicus (Verhoeff, 1891) - This species represents the first european Millipede verified in Brazil, by O. SCHUBART (1942a). The Author obtained a few specimens associated with O. gracilis, from the roots of lettuce plants. The lesions shown by the stem just above the roots seem to be due to both species. 4) Alloporus setiger Broelemann, 1902; Gymnostreptus olivaceus Schubart, 1944 and Pseudonannolene tricolor Broelemann, 1902 - Total damages determined by these species (mainly G. olivaceus) were observed in cultures of sugar-beet and melon. Actually, the Millipedes destroyed entirely the roots of the former plant and the fruits of the latter, representing a serious pest, here reported by the first time. Ecological and bionomical data are also included. 5) Pseudonannolene sp. (possibly P. paulista Broelemann, 1902) - Verified gnawing sweet-potatoes, about the crackings exhibited by the tubers. The crackings in sweet-potatoes appear to result in certain instances from a root-knot nematodes infection (Meloidogyne sp). P. paulista was recentely observed attacking potatoes, destroying from 6 to 30% of the tubers, according to the variety (BOOCK & LORDELLO, 1952).

Externalizing disorders and substance use: empirically derived subtypes in a population-based sample of adults.

PURPOSE: Attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) are common externalizing disorders of childhood. The common effects of these disorders on substance abuse need further investigation. The current study investigated the joint clusters of childhood/adolescence ADHD, CD, and ODD, and their influence on substance abuse/dependence in a population-based sample of adults. METHODS: The data were drawn from the PsyCoLaus study (n = 3,720) conducted in Lausanne, Switzerland. The population-based sample included 238 subjects meeting criteria for ADHD/ODD/CD diagnoses before the age of 15. Latent class analyses (LCA) were performed to derive comorbidity subtypes, which were subsequently characterized with respect to psychosocial correlates and substance use. RESULTS: The best fit in LCAs was achieved with three latent classes: an ADHD subtype (35.7 %); an externalizing multimorbid subtype (33.6 %) involving ODD, ADHD, and CD; and a third subtype with CD (30.7 %). The CD subtype showed the highest association with substance use. Apart from this, the externalizing multimorbid subtype was also significantly linked to substance use. The ADHD subtype had only elevated frequencies for alcohol dependence in comparison with subjects that had no history of ADHD, ODD, and CD during childhood or adolescence. Finally, important interactions between subtypes and sex were observed with regard to substance use. CONCLUSIONS: This study provides evidence showing that subtyping the externalizing disorders, ADHD, ODD and CD, along their comorbidity patterns leads to important differences regarding substance use. This could have implications for the etiology, prevention, and treatment of substance use disorders.

Reconstrucción del ligamento cruzado anterior desde el portal anteromedial; evaluación de la fijación femoral en un modelo cadavérico

Objectiu. Valorar el risc de lesió de les estructures posterolaterals del genoll realitzant una reconstrucció del Lligament Encreuat Anterior (LEA) mitjançant plàstia d’isquiotibials i fixació femoral am sistema Cross-Pin. Material. 10 genolls cadavèrics frescs. Reconstrucció artroscòpica del LEA mitjançant túnel anatòmic des del portal anteromedial. Dissecció anatòmica del genoll mesurant distàncies del Cross-Pin al Lligament Col•lateral Lateral (LCL), tendó popliti, nervi peroneo i tendó gastroecnemi lateral. Resultats. LCL i gastroecnemi tenen un alt risc de ser lesionats mitjançant aquest sistema Conclusió. El sistema de fixació Cross-Pin, com l’hem utilitzat, té un alt risc de lesionar les estructures laterals del genoll.

Environmental Tax on Products and Services Based on Their Carbon Footprint: A Case Study of the Pulp and Paper Sector

The main aim of this work is to define an environmental tax on products and services based on their carbon footprint. We examine the relevance of conventional life cycle analysis (LCA) and environmentally extended input-output analysis (EIO) as methodological tools to identify emission intensities of products and services on which the tax is based. The short-term price effects of the tax and the policy implications of considering non-GHG are also analyzed. The results from the specific case study on pulp production show that the environmental tax rate based on the LCA approach (1,8%) is higher than both EIO approaches (0,8% for product and 1,4% for industry approach), but they are comparable. Even though LCA is more product specific and provides detailed analysis, EIO would be the more relevant approach to apply economy wide environmental tax. When the environmental tax considers non-GHG emissions instead of only CO2, sectors such as agriculture, mining of coal and extraction of peat, and food exhibit higher environmental tax and price effects. Therefore, it is worthwhile for policy makers to pay attention on the implication of considering only CO2 tax or GHG emissions tax in order for such a policy measure to be effective and meaningful. Keywords: Environmental tax; Life cycle analysis; Environmental input-output analysis.

Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach.

BACKGROUND AND PURPOSE: Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities. METHODS: The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates. RESULTS: In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable. CONCLUSIONS: To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.

Prospettive e nuovi strumenti didattici per l'insegnamento della letteratura italiana

La tesi esplora le possibilità di rinnovamento e di riconfigurazione del ruolo del docente di lingua e letteratura italiana e, più in generale, del ruolo stesso della letteratura all'interno dei sistemi educativi, si colloca necessariamente all'intersezione tra diversi settori di studio: ? la didattica della letteratura italiana, una disciplina giovane, i cui inizi si possono far risalire agli anni Sessanta-Settanta del secolo scorso, situata all'incrocio tra linguistica, italianistica e teoria della letteratura, che ha contribuito alla messa a punto di metodi e di strumenti per l'insegnamento della letteratura soprattutto nel contesto scolastico; ? l'informatica umanistica, la disciplina che si occupa dell'interazione tra la tecnologia e il sapere umanistico, sia dal punto di vista dell'utilizzo dei mezzi digitali per la ricerca (la produzione, la ricerca, la rappresentazione e la conservazione delle informazioni), sia da quello del ruolo dei saperi umanistici nella struttura epistemologica e nella storia della digitalizzazione; ? la tecnologia dell'educazione, che a partire dai primi mezzi di comunicazione elettrici e, poi, dall'invenzione del computer, ha sviluppato concetti e metodi per un approccio critico alle tecnologie utilizzate intenzionalmente con finalità didattiche, sia nelle attività di istruzione in aula, sia nelle attività cosiddette a distanza. A contatto con concetti e strumenti elaborati in questi ambiti, quindi, lo studioso di letteratura italiana dovrebbe mettere in discussione concetti e strumenti tipici della propria disciplina, riflettere sul proprio ruolo di ricercatore e di docente nella produzione e distribuzione di contenuti disciplinari per la formazione degli studenti e, infine, individuare strumenti operativi che gli consentano di assumere il controllo sui processi di apprendimento e sul complesso rapporto che essi intrattengono con l'insegnamento.

Solid phase microextraction as a short-term sampling technique for BTEX occupational exposure

Solid phase microextraction (SPME) has been widely used for many years in various applications, such as environmental and water samples, food and fragrance analysis, or biological fluids. The aim of this study was to suggest the SPME method as an alternative to conventional techniques used in the evaluation of worker exposure to benzene, toluene, ethylbenzene, and xylene (BTEX). Polymethylsiloxane-carboxen (PDMS/CAR) showed as the most effective stationary phase material for sorbing BTEX among other materials (polyacrylate, PDMS, PDMS/divinylbenzene, Carbowax/divinylbenzene). Various experimental conditions were studied to apply SPME to BTEX quantitation in field situations. The uptake rate of the selected fiber (75 microm PDMS/CAR) was determined for each analyte at various concentrations, relative humidities, and airflow velocities from static (calm air) to dynamic (> 200 cm/s) conditions. The SPME method also was compared with the National Institute of Occupational Safety and Health method 1501. Unlike the latter, the SPME approach fulfills the new requirement for the threshold limit value-short term exposure limit (TLV-STEL) of 2.5 ppm for benzene (8 mg/m(3))

Concentrations of resveratrol and derivatives in foods and estimation of dietary intake in a Spanish population: European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort

Resveratrol has been shown to have beneficial effects on diseases related to oxidant and/or inflammatory processes and extends the lifespan of simple organisms including rodents. The objective of the present study was to estimate the dietary intake of resveratrol and piceid (R&P) present in foods, and to identify the principal dietary sources of these compounds in the Spanish adult population. For this purpose, a food composition database (FCDB) of R&P in Spanish foods was compiled. The study included 40 685 subjects aged 35–64 years from northern and southern regions of Spain who were included in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort. Usual food intake was assessed by personal interviews using a computerised version of a validated diet history method. An FCDB with 160 items was compiled. The estimated median and mean of R&P intake were 100 and 933 μg/d respectively. Approximately, 32 % of the population did not consume R&P. The most abundant of the four stilbenes studied was trans-piceid (53·6 %), followed by trans-resveratrol (20·9 %), cis-piceid (19·3 %) and cis-resveratrol (6·2 %). The most important source of R&P was wines (98·4 %) and grape and grape juices (1·6 %), whereas peanuts, pistachios and berries contributed to less than 0·01 %. For this reason the pattern of intake of R&P was similar to the wine pattern. This is the first time that R&P intake has been estimated in a Mediterranean country.

Residential Exposure to Outdoor Air Pollution during Pregnancy and Anthropometric Measures at Birth in a Multicenter Cohort in Spain

BACKGROUND. A growing body of research suggests that prenatal exposure to air pollution may be harmful to fetal development. We assessed the association between exposure to air pollution during pregnancy and anthropometric measures at birth in four areas within the Spanish Children's Health and Environment (INMA) mother and child cohort study. METHODS. Exposure to ambient nitrogen dioxide (NO2) and benzene was estimated for the residence of each woman (n = 2,337) for each trimester and for the entire pregnancy. Outcomes included birth weight, length, and head circumference. The association between residential outdoor air pollution exposure and birth outcomes was assessed with linear regression models controlled for potential confounders. We also performed sensitivity analyses for the subset of women who spent more time at home during pregnancy. Finally, we performed a combined analysis with meta-analysis techniques. RESULTS. In the combined analysis, an increase of 10 µg/m3 in NO2 exposure during pregnancy was associated with a decrease in birth length of -0.9 mm [95% confidence interval (CI), -1.8 to -0.1 mm]. For the subset of women who spent ≥ 15 hr/day at home, the association was stronger (-0.16 mm; 95% CI, -0.27 to -0.04). For this same subset of women, a reduction of 22 g in birth weight was associated with each 10-µg/m3 increase in NO2 exposure in the second trimester (95% CI, -45.3 to 1.9). We observed no significant relationship between benzene levels and birth outcomes. CONCLUSIONS. NO2 exposure was associated with reductions in both length and weight at birth. This association was clearer for the subset of women who spent more time at home.

Altered expression of beta-galactosidase-1-like protein 3 (Glb1l3) in the retinal pigment epithelium (RPE)-specific 65-kDa protein knockout mouse model of Leber's congenital amaurosis

Purpose: In this study, we investigated the expression of the gene encoding beta-galactosidase (Glb)-1-like protein 3 (Glb1l3), a member of the glycosyl hydrolase 35 family, during retinal degeneration in the retinal pigment epithelium (RPE)-specific 65-kDa protein knockout (Rpe65(-/-)) mouse model of Leber congenital amaurosis (LCA). Additionally, we assessed the expression of the other members of this protein family, including beta-galactosidase-1 (Glb1), beta-galactosidase-1-like (Glb1l), and beta-galactosidase-1-like protein 2 (Glb1l2).Methods: The structural features of Glb1l3 were assessed using bioinformatic tools. mRNA expression of Glb-related genes was investigated by oligonucleotide microarray, real-time PCR, and reverse transcription (RT) -PCR. The localized expression of Glb1l3 was assessed by combined in situ hybridization and immunohistochemistry.Results: Glb1l3 was the only Glb-related member strongly downregulated in Rpe65(-/-) retinas before the onset and during progression of the disease. Glb1l3 mRNA was only expressed in the retinal layers and the RPE/choroid. The other Glb-related genes were ubiquitously expressed in different ocular tissues, including the cornea and lens. In the healthy retina, expression of Glb1l3 was strongly induced during postnatal retinal development; age-related increased expression persisted during adulthood and aging.Conclusions: These data highlight early-onset downregulation of Glb1l3 in Rpe65-related disease. They further indicate that impaired expression of Glb1l3 is mostly due to the absence of the chromophore 11-cis retinal, suggesting that Rpe65 deficiency may have many metabolic consequences in the underlying neuroretina.

Prevention of the renarrowing of coronary arteries using drug-eluting stents in the perioperative period: an update.

The management of patients scheduled for surgery with a coronary stent, and receiving 1 or more antiplatelet drugs, has many controversies. The premature discontinuation of antiplatelet drugs substantially increases the risk of stent thrombosis (ST), myocardial infarction, and cardiac death, and surgery under an altered platelet function could also lead to an increased risk of bleeding in the perioperative period. Because of the conflict in the recommendations, this article reviews the current antiplatelet protocols after positioning a coronary stent, the evidence of increased risk of ST associated with the withdrawal of antiplatelet drugs and increased bleeding risk associated with its maintenance, the different perioperative antiplatelet protocols when patients are scheduled for surgery or need an urgent operation, and the therapeutic options if excessive bleeding occurs.