Aspiração de corpo estranho na criança: um perigo escondido

Introdução: A aspiração de corpo estranho (ACE) é uma emergência pediátrica e uma causa importante de morte acidental na criança. A maioria dos casos ocorre com objetos orgânicos e inorgânicos de pequenas dimensões, sobretudo em idade pré-escolar. A ACE cursa com amplo espectro de manifestações e o seu diagnóstico representa muitas vezes um desafio. Caso clínico: Descrevemos o caso clínico de uma criança de dois anos que recorreu ao Serviço de Urgência por tosse, disfonia e disfagia. Ao exame objetivo apresentava acessos de tosse estridulosa, tiragem supra-esternal ligeira e auscultação pulmonar com sibilos inspiratórios/expiratórios e roncos dispersos bilateralmente. A telerradiografia do tórax evidenciava um reforço hilar bilateral, mais notável à direita. A avaliação por Otorrinolaringologia, incluindo a nasolaringofibroscopia, não de- mostrou alterações. A broncoscopia revelou a presença de corpo estranho vegetal condicionando obstrução superior a 50% do lúmen do brônquio principal direito. Conclusão: Pretendemos com este caso salientar a necessidade de manter alto índice de suspeição perante a possibilidade de ACE, pois o atraso no seu reconhecimento condiciona o seu tratamento e o eventual aparecimento de sequelas irreversíveis.

Endoscopic incision for the treatment of refractory esophageal anastomotic strictures: outcomes of 13 cases with a minimum follow-up of 12 months

Background and aim: Endoscopic incision is an alternative method for refractory esophageal strictures; however, little is known about its long-term efficacy. The aim of the study is to assess the long-term outcomes of endoscopic incision for treating refractory esophageal anastomotic strictures. Methods: Between September 2011 and September 2014, 13 patients with refractory esophageal anastomotic strictures were treated with endoscopic incision. Their clinical data were retrospectively collected to evaluate the efficacy and safety of the technique. Results: All the 13 patients underwent the procedure successfully with median operation duration of 15 minutes. A total of 27 sessions were necessary to maintain lumen patency until September 2015, and 7 patients needed retreatment. The symptoms relieved in all the cases, and the median dysphagia score decreased from 4 to 1 during a median follow-up of 24 months. The median diameter of stricture was enlarged from 4 mm to 12 mm. As a short-term effect, dysphagia symptoms improved in 100% (13/13), 84.6% (11/13) and 76.9% (10/13) of the patients one, three and six months after a single treatment. As long-term effect, the dysphagia improved in 61.5% (8/13), 63.6% (7/11) and 60% (6/10) of the patients 12, 18 and 24 months after a single treatment. Conclusions: The efficacy of endoscopic incision is favorable in the short term. However, retreatment is needed to maintain the long-term lumen patency for parts of the patients.

Release currents of IP₃ receptor channel clusters and concentration profiles

We simulate currents and concentration profiles generated by Ca2+ release from the endoplasmic reticulum (ER) to the cytosol through IP3 receptor channel clusters. Clusters are described as conducting pores in the lumenal membrane with a diameter from 6 nm to 36 nm. The endoplasmic reticulum is modeled as a disc with a radius of 1–12 mm and an inner height of 28 nm. We adapt the dependence of the currents on the trans Ca2+ concentration (intralumenal) measured in lipid bilayer experiments to the cellular geometry. Simulated currents are compared with signal mass measurements in Xenopus oocytes. We find that release currents depend linearly on the concentration of free Ca2+ in the lumen. The release current is approximately proportional to the square root of the number of open channels in a cluster. Cytosolic concentrations at the location of the cluster range from 25 μM to 170 μM. Concentration increase due to puffs in a distance of a few micrometers from the puff site is found to be in the nanomolar range. Release currents decay biexponentially with timescales of < 1 s and a few seconds. Concentration profiles decay with timescales of 0.125–0.250 s upon termination of release.

An investigation into the properties of non-digestible carbohydrates that selectively promote colonic propionate production

Short chain fatty acids (SCFA), including propionate, are produced by the bacterial fermentation of carbohydrates in the colon. Propionate has many potential roles in health, including inhibiting cholesterol synthesis, de novo lipogenesis and increasing satiety. The profile of SCFA produced is determined by both the substrate available and the bacteria present and may be influenced by environmental conditions within the lumen of the colon. Whilst it may be beneficial to increase colonic propionate production, dietary strategies to achieve this are unproven. Adding propionate to food leads to poorer organoleptic properties, and oral propionate is absorbed in the small intestine. The optimum way to selectively increase colonic propionate would be to select fermentable carbohydrates that selectively promote propionate production. To date, few studies have undertaken a systematic assessment of the factors leading to increased colonic propionate production making the selection of propiogenic carbohydrates challenging. The aim of this thesis was to identify the best carbohydrates for selectively increasing propionate production, and to explore the factors which control propionate production. This work started with a systematic review of the literature for evidence of candidate carbohydrates, which led to a screen of ‘propiogenic’ substrates using in vitro batch fermentations and mechanistic analysis of the impact of pH, bond linkage and orientation using a range of sugars, polysaccharides and fibre sources. A new unit for SCFA production was developed to allow comparison of results from in vitro studies encompassing a range different methodologies found in the literature. The systematic review found that rhamnose yielded the highest rate and proportion of propionate production whereas, for polysaccharides, β-glucan ranked highest for rate and guar gum ranked highest for molar production, but this was not replicated across all studies. Thus, no single NDC was established as highly propiogenic. Some substrates appeared more propiogenic than others and when these were screened in vitro. Laminarin, and other β-glucans ranked highest for propionate production. Legume fibre and mycoprotein fibre were also propiogenic. A full complement of glucose disaccharides were tested to examine the role glycosidic bond orientation and position on propionate production. Of the glucose disaccharides tested, β(1-4) bonding was associated with increased proportion of propionate and α(1-1) and β(1-4) increased the rate and proportion of butyrate production. In conclusion, it appears that for fibre to affect satiety, high intakes of fibre are needed, and which a major mechanism is thought to occur via propionate. Within this thesis it was identified that rather than selecting specific fibres, increasing overall intakes of highly fermentable carbohydrates is as effective at increasing propionate production. Selecting carbohydrates with beta-bonding, particularly laminarin and other β(1-4) fermentable carbohydrates leads to marginal increases in propionate production. Compared with targeted delivery of propionate to the colon, fermentable carbohydrates examined in this thesis have lesser and variable effects on propionate production. A more complete understanding of the impact of bond configurations in polysaccharides, rather than disaccharides, may help selection or design of dietary carbohydrates which selectively promote colonic propionate production substrates for inclusion in functional foods. Overall this study has concluded that few substrates are selectively propiogenic and the evidence suggests that similar changes in propionate production may be achieved by modest changes in dietary fibre intake

A microestrutura e o desenvolvimento dos órgãos genitais masculinos de preás (Galea spixii) criados em cativeiro

O preá do semiárido nordestino (Galea spixii) é um roedor pertencente à família Caviidae. São encontrados nas regiões da Caatinga e do Cerrado Brasileiro e se reproduz ao longo do ano, apresentando um período de gestação de 48 dias e uma ninhada de 2 a 4 crias. O objetivo deste estudo foi caracterizar histologicamente os componentes estruturais dos órgãos genitais de preás machos relacionando com a evolução cronológica destes órgãos na espécie. Foram utilizados para análise animais ao nascimento e aos 15, 30, 45, 60, 75, 90, 105, 120 e aos 150 dias de idade. Fragmentos do epidídimo, ducto deferente, pênis e glândulas sexuais acessórias foram coletados, fixados e processados para descrição em microscopia de luz. O epidídimo apresentou epitélio colunar simples e em cada fase sexual notou-se diferença quanto ao tamanho do lúmen tubular e à presença de espermatozóides no lúmen aos 45 dias de idade. O epitélio do ducto deferente no preá mostrou-se pseudo-estratificado colunar com crescente presença de estereocilios com o avanço da idade. A glândula vesicular no preá apresentou uma mucosa com pregueamento variado, de acordo com a fase do desenvolvimento sexual. A próstata mostrou-se pouco desenvolvida, com lúmen pequeno nos preás ao nascimento e aos 15 dias de idade; aos 45 dias mostrou-se com um pregueamento do epitélio variável. Os órgãos genitais masculinos do preá passaram por transformações morfológicas no decorrer da idade e com o desenvolvimento sexual, isso colaborou para a determinação do início da fase da puberdade, que na espécie em estudo foi aos 45 dias de idade.

Fases do desenvolvimento e diferenciação testicular em cutias (Dasyprocta aguti) criadas em cativeiros

A cutia (Dasyprocta aguti) é um roedor silvestre encontrado amplamente na região Nordeste do Brasil. É uma espécie muito utilizada pela população humana de baixa renda como fonte alternativa de proteína na alimentação. Foram utilizadas 31 cutias, machos, provenientes da Universidade Federal do Piauí (FUFPI), Estado do Piauí e da Escola Superior de Agricultura de Mossoró Estado do Rio Grande do Norte. Os animais foram divididos em grupos etários desde o nascimento até os 14 meses de idade. O diâmetro nuclear médio foi obtido pela medida de 10 núcleos do tipo celular estudado em cada testículo, no estágio 1 do ciclo do epitélio seminífero. Nos animais que não apresentaram o epitélio organizado em estágios bem definidos em virtude da idade, foram feitas medidas em secções transversais escolhidas somente pelo contorno circular. O início da assincronia do processo espermatogênico foi observado a partir dos seis meses de idade. A puberdade, na cutia Dasyprocta aguti, foi definitivamente estabelecida a partir dos nove meses de idade, pois estavam presentes todos os tipos celulares e espermatozóides liberados no lume tubular em grande parte do parênquima testicular.

Towards a predictive model of Ca²⁺ puffs

We investigate key characteristics of Ca²⁺ puffs in deterministic and stochastic frameworks that all incorporate the cellular morphology of IP[subscript]3 receptor channel clusters. In a first step, we numerically study Ca²⁺ liberation in a three dimensional representation of a cluster environment with reaction-diffusion dynamics in both the cytosol and the lumen. These simulations reveal that Ca²⁺ concentrations at a releasing cluster range from 80 µM to 170 µM and equilibrate almost instantaneously on the time scale of the release duration. These highly elevated Ca²⁺ concentrations eliminate Ca²⁺ oscillations in a deterministic model of an IP[subscript]3R channel cluster at physiological parameter values as revealed by a linear stability analysis. The reason lies in the saturation of all feedback processes in the IP[subscript]3R gating dynamics, so that only fluctuations can restore experimentally observed Ca²⁺ oscillations. In this spirit, we derive master equations that allow us to analytically quantify the onset of Ca²⁺ puffs and hence the stochastic time scale of intracellular Ca²⁺ dynamics. Moving up the spatial scale, we suggest to formulate cellular dynamics in terms of waiting time distribution functions. This approach prevents the state space explosion that is typical for the description of cellular dynamics based on channel states and still contains information on molecular fluctuations. We illustrate this method by studying global Ca²⁺ oscillations.

Spermathecae of the mangrove crab Ucides cordatus: a histological and histochemical view

Ucides cordatus is the most commercially, important mangrove crab in Brazil. In spite of its economic importance, there are few studies of its reproduction, in particular the female reproductive system. The present study describes the histology and histochemistry of the spermathecae of U. cordatus. Adult females were can lit monthly from July 2004 through June 2005, at Iguape, State of São Paulo. The crabs were anaesthetized, and their spermathecae removed and fixed in Davidson's fluid, following the histological routine for paraffin. The slides were stained with HE, xylidine Ponceau, PAS, alcian blue (pH 1.0 and 2.5), Sudan black B and picrosirius-haematoxylin. Histologically, the spermathecae possesses a capsule of conjunctive tissue, rich in collalgen fibres, which surrounds the secretory columnar epithelium. In the lumen, individual sperm packets are not observed; the spermatophores are intermixed with the seminal fluid and secretions of the spermathecae itself. A large proportion of the free spermatozoids and spermatophores are arranged in homogeneous masses in the proximal part of the spermathecae. The secretion produced by the columnar epithelium appears to promote the movement of the gametes to the fertilization chamber, in a ventral position, allowing fertilization of the oocytes. Histochemically, the secretion produced by the columnar epithelium was strongly positive for neutral polysaccharides, positive for acid polysaccharides, and weakly positive for proteins and lipids. Tills secretion forms a glycoprotein matrix which is associated with maintenance of the spermatophores, which can remain stored for long periods.

Renal- and calcium-dependent vascular effects of Polybia paulista wasp venom

In the present study, the effects of Polybia paulista venom (PPV) on renal and vascular tissues were investigated. Isolated kidneys perfused with PPV (1 and 3 mu g/mL) had increased perfusion pressure, renal vascular resistance, urinary flow, and glomerular filtration rate; and reduced sodium tubular transport. Histological evaluation demonstrated deposits of proteins in Bowman's space and tubular lumen, and focal areas of necrosis. The venom promoted a cytotoxic effect on Madin-Darby canine kidney (MDCK) cells. A significant increase in lactic dehydrogenase levels was observed in response to venom exposure. In isolated mesenteric vascular beds, pressure and vascular resistance augmented in a dose-dependent manner. PPV increased the contractility of aortic rings maintained under basal tension. This contractile response was inhibited when preparations were maintained in Ca2+-free medium. Likewise, verapamil, a voltage-gated calcium channel blocker, also inhibited the contractile response. In this study, phentolamine, a blocker of a-adrenergic receptor blocker, significantly reduced the contractile effect of PPV in the aortic ring. In conclusion, PPV produced nephrotoxicity, which suggests a direct effect on necrotic cellular death in renal tubule cells. The vascular contractile effect of PPV appears to involve calcium influx through voltage-gated calcium channels via adrenergic regulation.

Athanasii Kircheri Fuldensis Buchonii... Ars magna lucis et umbrae, in decem libros digesta. Quibus admirandae lucis et umbrae in mundo, atque adeò vniuersa natura, vires effectusq. vti noua, uti varia nouorum reconditiorumq. speciminum exhibitione, ad varios mortalium vsus, panduntur...

En port. grab. xil. de sol con lema: "Sicuti tenebrae eius ita & lumen eius. Psal. 138"

El fracaso en los emprendedores colombianos: una aproximación desde la logística

El objetivo de esta investigación se centra en el análisis de los factores que inciden con mayor frecuencia en el fracaso de los emprendimientos en Colombia, y considerar su proximidad con el concepto de logística como actividad elemental para el desarrollo de los emprendimientos en el país. La finalidad de esta investigación es mostrar que los patrones que conducen al fracaso, los cuales están catalogados dentro de las categorías financiera, organizacional, operativa, de entorno, de mercadeo o de recursos humanos, tienen un nivel de incidencia dentro del fracaso, por lo cual, se puede ejecutar un análisis que permita demostrar el orden de las seis categorías mencionadas según su impacto dentro del fracaso y a su vez, brindar estrategias que permitan reducir las posibilidades de fracasar en los emprendimientos.

EL NOS-OTROS-ORIGINARIO: Sobre la posibilidad de respetar los derechos de el-otro

Este texto plantea la posibilidad de recuperar el nos-otros-originario como clave para la superación del «sufrimiento inútil» del sujeto; de este modo, muestra al nos-otros-originario como una zona de protección de los derechos de el-otro, hace una crítica en contra del nos-otros-caído como vulnerador de derechos fundamentales, y aborda la posibilidad de recuperar el nos-otros-originario a través de una consumación definitiva de la "justicia".

Papel de la comunidad internacional en la resocialización de niños soldados desvinculados del ejército de resistencia del señor en Uganda (2002-2013)

El objetivo de esta investigación diagnóstica es evaluar las acciones de la Comunidad Internacional en materia de resocialización de niños soldados desvinculados del Ejército de Resistencia del Señor (ERS) en Uganda durante el periodo de 2002 a 2013. Para ello, se hace un análisis de las causas de la existencia de niños soldados, donde se tiene en cuenta la evolución del concepto de la infancia y las particularidades que éste representa en el contexto africano. Así mismo, son analizados los alcances y limitaciones del modelo de asistencia humanitaria para la protección de la niñez enfatizando en los procesos de resocialización brindados a los niños desvinculados del ERS. Esto con el fin de evidenciar las limitaciones de la actuación de la Comunidad Internacional, y brindar una serie de recomendaciones para la implementación de programas de resocialización enfocados en la infancia.

Hacia la construcción de un diagnóstico de educación para la paz en el colegio IED José Joaquín Castro Martínez

El presente proyecto se enmarca como un informe diagnóstico sobre la educación para la paz en el IED José Joaquín Castro Martínez. Es importante resaltar que este informe no pretende abarcar aspectos investigativos sobre el conflicto, la violencia escolar o la educación para la paz; lo que se busca es a partir de un diagnóstico del colegio posibilitar un posterior diseño de una estrategia de intervención para esta institución educativa ubicada en la localidad de San Cristóbal en la ciudad de Bogotá. Este diagnóstico pretende ser una avance en este tipo de experiencias en el colegio, el cual se espera propicie un impacto positivo en las dinámicas del conflicto que viven día a día los estudiantes de la institución educativa reseñada, y propiciar así un mayor conocimiento de las problemáticas de los y las estudiantes en relación a una cultura de paz, entendida esta desde 4 aspectos: primero el respeto a sí mismo, al otro y a su entorno; segundo, resolución y resignificacion positiva del conflicto; tercero, prevención del consumo de SPA; y cuarto convivencia escolar.

Subjetividades políticas desde la representación : fotografía documental del campesinado en Colombia (1965-1975)

Esta investigación explora arqueológicamente el saber constituido sobre el campesinado en Colombia, en el período de 1965-1975, tomando como material empírico principal un archivo fotográfico documental que relacionaremos con hemerografía y las reconstrucciones socio-históricas de la década. Nuestro propósito es relacionar el archivo, sus condiciones, su porvenir, medios y definiciones con la constitución de subjetividades políticas. Las subjetividades son entendidas aquí en tanto procesos que al referir universos simbólicos socialmente compartidos, dotan al sujeto de un lenguaje cultural que a continuación internaliza, y adquiere así una singularidad que lo caracteriza y finalmente lo representa como “ser colectivo”. Descifraremos, a través de lo visible y lo oculto de las representaciones fotográficas, los enunciados posibles y las aproximaciones desde la sociología. Veremos como los discursos, por demás contradictorios, fungen a manera de proyectos de homogeneización de la cultura campesina efectuándose en la esfera de la heterogeneidad: campesinos marcados por diferencias entre sí, multiplicidad de subjetividades implicadas políticamente en los procesos inscritos dentro de la reforma agraria.