Fatores preditivos do maior número de estádios na cirurgia micrográfica de Mohs para o tratamento do carcinoma espinocelular da cabeça

FUNDAMENTOS: Os carcinomas espinocelulares da pele da cabeça têm como opção terapêutica mais segura a cirurgia micrográfica de Mohs, que apresenta os menores índices de recidiva e a máxima preservação tecidual. Características dos carcinomas espinocelulares podem estar relacionadas a maior número de estádios cirúrgicos. OBJETIVO: Definir características dos carcinomas espinocelulares que sejam preditoras de maior número de estádios na cirurgia de Mohs. MÉTODOS: Análise retrospectiva de 51 carcinomas espinocelulares da cabeça tratados pela cirurgia de Mohs para determinar fatores de risco de maior número de estádios. Foram analisados limites clínicos, morfologia, recidiva, histologia e tamanho, relacionando-os ao número de estádios cirúrgicos. A análise estatística foi realizada pelo teste exato de Fisher e regressão logística multivariada. RESULTADOS: Os carcinomas recidivados tiveram tendência a maior número de estádios (p=0,081). Os tumores com limites imprecisos apresentaram três vezes mais possibilidades de maior número de fases na análise da razão de chances. Esse achado foi compatível com dados da literatura, apesar de não ter sido estatisticamente significante. CONCLUSÃO: Características pré-operatórias dos carcinomas espinocelulares, como recidiva e limites imprecisos, apesar de não preditivas, indicaram tendência a maior número de estádios na cirurgia micrográfica de Mohs.

Ateliê de desenho e Rorschach: estudo fenômeno-estrutural

A produção de desenhos em grupo e o método de Rorschach foram utilizados ao longo do tratamento de um paciente com esquizofrenia, acompanhado em Centro de Atenção Psicossocial. O referencial proposto para a compreensão do caso é o método fenômeno-estrutural que busca acessar o modo de ser e de vivenciar a doença que afeta o paciente, a partir do que ele revela nas imagens e na linguagem. Aos desenhos de cores acromáticas e conteúdos humanos deformados, o paciente insere cores, representantes da expressão afetiva, e figuras humanas integradas, denotando disponibilidade nas relações. O Rorschach indica contato mais adequado com a realidade, dado a diminuição da distorção da percepção da forma e de figuras fantasiosas. Após diminuição da sintomatologia persecutória e isolamento social, o paciente recebeu alta. O uso desses instrumentos tem contribuído na difícil tarefa diagnóstica e no acompanhamento da evolução de pacientes, nos cuidados interdisciplinares em saúde mental.

Characterization studies of 1-(4-cyano-2-oxo-1,2-dihydro-1-pyridyl)-3-(4-cyano-1,2-dihydro-1-pyridyl)propane formed from the reaction of hydroxide Ion with 1,3-Bis-(4-cyano pyridinium)propane

The aqueous alkaline reaction of 1,3-bis(4-cyanopyridinium)propane dibromide, a reactant constituted of two pyridinium rings linked by a three-methylene bridge, generates a novel compound,1 -(4-cyano-2-oxo-1,2-dihydro-1-pyridyl)-3-(4-cyano-1,2-dihydro-1-pyridyl)propane. The reaction pathway is attributed to the proximity of the OH- ion inserted between two pyridinium moieties, which occurs only in bis(pyridinium) derivatives connected by short methylene spacers, where charge-conformational effects are important.

Impactos na saúde das deficiências de acesso a água

O acesso regular à água potável e segura tem causado preocupação, principalmente em países em desenvolvimento e, mais enfaticamente em áreas periurbanas, que abrigam a população socialmente excluída. O objetivo deste trabalho é abordar questões de acesso à água em regiões periurbanas e para tanto foi realizado levantamento bibliográfico nas bases de dados Pubmed, Medline e SciELO assim como relatórios da OMS, OPAS, IBGE e Ministério das Cidades. A falta ou a precariedade do acesso à água representa situação de risco que propicia aumento da incidência de doenças infecciosas agudas e da prevalência de doenças crônicas. O estabelecimento do grau de acesso à água de qualidade considera fatores como distância e tempo percorrido até a fonte de água, volume coletado, demanda atendida e nível de prioridade de ações de intervenção. Na qualidade da água, consideram-se como fatores de impacto o manuseio - maneira como ocorre a coleta, o transporte, o armazenamento e o uso -, a presença de patógenos nas fontes e as práticas rotineiras da população. A determinação da presença de patógenos nas fontes evidencia o risco à saúde e a identificação do agente etiológico indica a origem da contaminação. O caminho para reverter esse cenário é a implementação integrada de políticas públicas de gestão, que envolvam ações conjuntas e ajustadas nos setores de desenvolvimento urbano, habitação, saneamento e saúde e que visem à promoção e à proteção da saúde da população local e ao enfrentamento da complexidade de fatores que evidenciam sua vulnerabilidade.

Influência do bloqueador de receptor de angiotensina (Losartana potássica) na função renal e pressão arterial em cães GRMD

A distrofia muscular de Duchenne (DMD) é uma alteração neuromuscular caracterizada por contínua necrose muscular e degeneração, com eventual fibrose e infiltração por tecido adiposo. O aumento progressivo da fibrose intersticial no músculo impede a migração das células miogênicas, necessárias para a formação muscular. O modelo canino constitui-se nas melhores fenocópias da doença em humanos, quando comparados com outros modelos animais com distrofia. O tratamento antifibrose de pacientes DMD, tendo como alvo os mediadores da citocina, TGF-beta, e o tratamento com antiinflamatórios, podem limitar a degeneração muscular e contribuir para a melhora do curso da doença. O presente estudo teve como objetivo observar os possíveis efeitos adversos na fisiologia renal, por meio de avaliação bioquímica sanguínea e da pressão arterial, verificando a viabilidade do uso do Losartan (um inibidor de TGF-beta) nos cães afetados pela distrofia muscular. Foram utilizados quatro cães adultos, sendo dois machos e duas fêmeas. Utilizou-se a dose de 50mg de Losartan, administrada via oral, uma vez ao dia. Os exames clínicos, bem como alterações na função renal, o nível do potássio sérico e a pressão arterial não evidenciaram reação adversa durante todo o período do experimento. O uso de Losartan, por um período de 9 semanas, mostrou-se como uma terapia segura para o tratamento antifibrótico em cães adultos, não afetando a função renal ou pressão arterial dos animais.

Factors associated with sexual initiation and condom use among adolescents on Santiago Island, Cape Verde, West Africa

Foram analisados fatores associados ao início da vida sexual de adolescentes na Ilha de Santiago, Cabo Verde, segundo sexo. Estudo realizado com amostra probabilística e representativa de 768 adolescentes, age 13-17 anos, de escolas secundárias públicas da Ilha de Santiago em 2007. A associação foi testada pelo teste de proporção, qui-quadrado de Pearson ou Fisher e regressão logística. Nos rapazes, os fatores associados ao início da vida sexual foram: idade maior que 14 anos, ser católico e consumo de bebidas alcoólicas. Para meninas: escolaridade maior que nove anos e ter parceiro afetivo-sexual. Ao contrário de outros contextos da África Subsaariana, foram constatadas taxas elevadas de uso de preservativo por adolescentes no início da vida sexual. Os adolescentes podem iniciar a vida sexual de maneira mais segura se tiverem informação, educação sexual e acesso a métodos de prevenção à gravidez e às DST. Este artigo oferece elementos para a reflexão sobre o delineamento de políticas de redução da vulnerabilidade dos jovens às DST/AIDS e sobre os limites e desafios da promoção do uso do preservativo e educação sexual, focando as relações desiguais de gênero

Tetraploidization in Wilms tumor in an infant

Genetic instability is frequent in human cancer. Unscheduled tetraploidization can trigger cell transformation and tumorigenesis. We made a cytogenetic analysis by Giemsa-trypsin banding of a stage I, biphasic Wilms tumor diagnosed in a 10-month-old male. An evident karyotypic heterogeneity was found. Four different subclones of tumor cells were observed, with DNA content varying from diploid to near-tetraploid complements. The genetic events involved in the acquisition of aneuploidy in Wilms tumor remain unclear. We hypothesize that initial tetraploidization caused aberrant cell division, leading to abnormal chromosomal segregation, cell transformation and tumorigenesis.

Yellow Fever Virus in Haemagogus leucocelaenus and Aedes serratus Mosquitoes, Southern Brazil, 2008

Yellow fever virus (YFV) was isolated from Haemagogus leucocelaenus mosquitoes during an epizootic in 2001 in the Rio Grande do Sul State in southern Brazil In October 2008 a yellow fever outbreak was reported there with nonhuman primate deaths and human cases This latter outbreak led to intensification of surveillance measures for early detection of YFV and support for vaccination programs We report entomologic surveillance in 2 municipalities that recorded nonhuman primate deaths Mosquitoes were collected at ground level identified and processed for virus isolation and molecular analyses Eight YFV strains were isolated (7 from pools of Hg leucocelaenus mosquitoes and another from Aedes serratus mosquitoes) 6 were sequenced and they grouped in the YFV South American genotype I The results confirmed the role of Hg leucocelaenus mosquitoes as the main YFV vector in southern Brazil and suggest that Ae serratus mosquitoes may have a potential role as a secondary vector

Effect of terbium(III) on the binding of aromatic guests with sodium taurocholate aggregates

The effect of binding Tb(3+) to sodium taurocholate aggregates containing polyaromatic hydrocarbon guests was examined using pyrene and 1-ethylnaphthalene as guests that bind to the primary aggregate, and 1-naphthyl-1-ethanol as a secondary aggregate guest. Time-resolved fluorescence quenching studies were used to study the binding site properties, while laser flash photolysis quenching studies provided information on the dynamics of the guest-aggregate system. Both the primary and secondary aggregate binding sites became more compact in the presence of bound Tb(3+), while only the primary aggregate became more accessible to anionic molecules. The binding dynamics for the guest-primary aggregate system became faster when Tb(3+) was bound to the aggregate. In contrast, for the guest-secondary aggregate the presence of Tb(3+) resulted in a small decrease in the dissociation rate constant. The influence of bound Tb(3+) on the primary and secondary bile salt aggregates is significantly different, which affects how these aggregates can be used as supramolecular host systems to modify guest reactivity.

DISTRIBUTION OF CAPYBARAS IN AN AGROECOSYSTEM, SOUTHEASTERN BRAZIL, BASED ON ECOLOGICAL NICHE MODELING

Southeastern Brazil has seen dramatic landscape modifications in recent decades, due to expansion of agriculture and urban areas; these changes have influenced the distribution and abundance of vertebrates. We developed predictive models of ecological and spatial distributions of capybaras (Hydrochoerus hydrochaeris) using ecological niche modeling. Most Occurrences of capybaras were in flat areas with water bodies Surrounded by sugarcane and pasture. More than 75% of the Piracicaba River basin was estimated as potentially habitable by capybara. The models had low omission error (2.3-3.4%), but higher commission error (91.0-98.5%); these ""model failures"" seem to be more related to local habitat characteristics than to spatial ones. The potential distribution of capybaras in the basin is associated with anthropogenic habitats, particularly with intensive land use for agriculture.

Analysis of Bacteria, Parasites, and Heavy Metals in Lettuce (Lactuca sativa) and Rocket Salad (Eruca sativa L.) Irrigated with Treated Effluent from a Biological Wastewater Treatment Plant

This study aimed to evaluate the viability of using treated residuary water from the Biological Wastewater Treatment Plant of Ribeiro Preto to grow vegetables, through the characterization and quantification of parasites, coliforms, and heavy metals. Three equal cultivation areas were prepared. The first was irrigated with treated/chlorinated (0.2 mg L(-1)) wastewater, the second one with treated wastewater without chlorination, and the third site with potable water, which was the control group. The presence of Hymenolepis nana, Enterobius vermicularis, nematode larvae, and Entamoeba coli was verified in lettuce (Lactuca sativa) samples. Although nematode larvae were observed in rocket salad (Eruca sativa L.), no significant differences were found between the number of parasites and type of irrigation water used. No significant differences were found between the number of fecal coliforms in vegetables and the different types of irrigation. However, the vegetables irrigated with treated effluent without chlorination showed higher levels of fecal coliforms. The risk of pathogens is reduced with bleach addition to the treated effluent at 0.2 mg/L. Concentration of heavy metals in vegetables does not mean significant risks to human health, according with the parameters recommended by the World Health Organization.

Feasibility of Electronic Tap-Changing Stabilizers for Medium Voltage Lines-Precedents and New Configurations

Thyristor-based onload tap-changing ac voltage stabilizers are cheap and robust. They have replaced most mechanical tap-changers in low voltage applications from 300 VA to 300 M. Nevertheless, this replacement hardily applies to tap-changers associated to transformers feeding medium-voltage lines (typically 69 kV primary, 34.5 kV line, 10 MVA) which need periodical maintenance of contacts and oil. The Electric Power Research Institute (EPRI) has studied the feasibility of this replacement. It detected economical problems derived from the need for series association of thyristors to manage the high voltages involved, and from the current overload developed under line fault. The paper reviews the configurations used in that field and proposes new solutions, using a compensating transformer in the main circuit and multi-winding coils in the commutating circuit, with reduced overload effect and no series association of thyristors, drastically decreasing their number and rating. The stabilizer can be installed at any point of the line and the electronic circuit can be fixed to ground. Subsequent works study and synthesize several commutating circuits in detail.

On the finite element modeling of fatigue crack growth in pressurized cylindrical shells

A methodology for the computational modeling of the fatigue crack growth in pressurized shell structures, based on the finite element method and concepts of Linear Elastic Fracture Mechanics, is presented. This methodology is based on that developed by Potyondy [Potyondy D, Wawrzynek PA, Ingraffea, AR. Discrete crack growth analysis methodology for through crack in pressurized fuselage structures. Int J Numer Methods Eng 1995;38:1633-1644], which consists of using four stress intensity factors, computed from the modified crack integral method, to predict the fatigue propagation life as well as the crack trajectory, which is computed as part of the numerical simulation. Some issues not presented in the study of Potyondy are investigated herein such as the influence of the crack increment size and the number of nodes per element (4 or 9 nodes) on the simulation results by means of a fatigue crack propagation simulation of a Boeing 737 airplane fuselage. The results of this simulation are compared with experimental results and those obtained by Potyondy [1]. (C) 2008 Elsevier Ltd. All rights reserved.

Kinetics and Modeling of Fatty Alcohol Ethoxylation in an Industrial Spray Loop Reactor

The kinetics of the ethoxylation of fatty alcohols catalyzed by potassium hydroxide was studied to obtain the rate constants for modeling of the industrial process. Experimental data obtained in a lab-scale semibatch autoclave reactor were used to evaluate kinetic and equilibrium parameters. The kinetic model was employed to model the performance of an industrial-scale spray tower reactor for fatty alcohol ethoxylation. The reactor model considers that mass transfer and reaction occur independently in two distinct zones of the reactor. Good agreement between the model predictions and real data was found. These findings confirm the reliability of the kinetic and reactor model for simulating fatty alcohol ethoxylation processes under industrial conditions.

LPS Removal from an E. Coli Fermentation Broth Using Aqueous Two-Phase Micellar System

In biotechnology, endotoxin (LPS) removal from recombinant proteins is a critical and challenging step in the preparation of injectable therapeutics, as endotoxin is a natural component of bacterial expression systems widely used to manufacture therapeutic proteins. The viability of large-scale industrial production of recombinant biomolecules of pharmaceutical interest significantly depends on the separation and purification techniques used. The aim of this work was to evaluate the use of aqueous two-phase micellar system (ATPMS) for endotoxin removal from preparations containing recombinant proteins of pharmaceutical interest, such as green fluorescent protein (GFPuv). Partition assays were carried out initially using pure LPS, and afterwards in the presence of E. coli cell lysate. The ATPMS technology proved to be effective in GFPuv recovery, preferentially into the micelle-poor phase (K(GFPuv) < 1.00), and LPS removal into the micelle-rich phase (%REM(LPS) > 98.00%). Therefore, this system can be exploited as the first step for purification in biotechnology processes for removal of higher LPS concentrations. (C) 2010 American Institute of Chemical Engineers Biotechnol. Prog., 26: 1644-1653, 2010