299 resultados para Fistula


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Sponge spicules are siliceous microfossils that are especially useful for analysis of sandy fluvio-lacustrine sediments. Sponge spicules in a long sediment core (~550 cm below surface), consisting of fine sand, sandy silt, and organic-rich mud, recovered from the floodplain of the Nabileque River, southern Pantanal, Brazil (S20°16′38. 3″/W57°33′00. 0″), form the basis of a novel paleoenvironmental interpretation for this region. Optically stimulated luminescence dates constrain the timing of deposition to the middle-late Holocene and all spicules identified are typical of the Brazilian cerrado biome. The base of the section is dominated by Oncosclera navicella Carter 1881, Metaniaspinata Carter 1881, and Corvospongilla seckti Bonetto and Ezcurra de Drago 1966, which indicate a lotic to semi-lotic environment strongly influenced by an actively meandering river channel at ~6. 7-5. 7 ka BP. The appearance of Heterorotula fistula Volkmer-Ribeiro and Motta 1995, Dosilia pydanieli Volkmer-Ribeiro 1992 and Radiospongilla amazonensis Volkmer-Ribeiro and Maciel 1983 at ~340 cm downcore suggests a reduction in flowing water and a more stable lentic environment, consistent with deposition in an oxbow lake. This oxbow lake environment existed during an interval of regional aridity between ~4. 5 and 3. 9 ka BP. Spicules, as well as phytoliths and diatoms, are highly variable moving up-section, with species from both lotic and lentic ecosystems present. Above ~193 cm, the total abundance of spicules declines, consistent with wetter climate conditions and development of an underfit river similar to the modern floodplain. Results support hypotheses related to migration of the Paraguay River inferred from geomorphological studies and add a key southern-region dataset to the emerging Holocene database of paleoenvironmental records from the Pantanal wetlands. © 2012 Springer Science+Business Media Dordrecht.

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Purpose: It is recognized that chronic inflammation can cause cancer. Even though most of the available synthetic meshes are considered non-carcinogenic, the inflammatory response to an infected mesh plays a constant aggression to the skin. Chronic mesh infection is frequently the result of misuse of mesh, and due to the challenging nature of this condition, patients usually suffer for years until the infected mesh is removed by surgical excision. Methods: We report two cases of squamous-cell carcinoma (SCC) of the abdominal wall, arising in patients with long-term mesh infection. Results: In both patients, the degeneration of mesh infection into SCC was presumably caused by the long-term inflammation secondary to infection. Patients presented with advanced SCC behaving just like the Marjolin's ulcers of burns. Radical surgical excision was the treatment of choice. The involvement of the bowel played an additional challenge in case 1, but it was possible to resect the tumor and the involved bowel and reconstruct the abdominal wall using polypropylene mesh as onlay reinforcement, in a single stage operation. He is now under adjuvant chemotherapy. The big gap in the midline after tumor resection in case 2 required mesh bridging to close the defect. The poor prognosis of case 2 who died months after the operation, and the involvement of the armpit, groin and mesenteric nodes in case 1 shows how aggressive this disease can be. Conclusion: Infected mesh must be treated early, by complete excision of the mesh. Long-standing mesh infection can degenerate into aggressive squamous-cell carcinoma of the skin. © 2013 Springer-Verlag France.

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In vitro production and somatic cell nuclear transfer are biotechnologies widely used for breeding cattle, although may result in congenital anomalies. This paper aims to report a set of congenital anomalies in two Nelore calves, a male and a female, produced through in vitro fertilization. The major anomalies revealed at necropsy were hypospadias, bifid scrotum, atresia ani and rectum ending in blind pouch in the male calf. In the female calf accessory spleen, atresia ani, underdevelopment of extern genitalia and urethral orifice, and rectum ending in blind pouch forming a uterus-rectum fistula were observed.

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The aim of this paper was to report the diagnosis and evaluation of periradicular bone repair by using computed tomography and digital subtraction radiography in an endodontic surgery case treated with mineral trioxide aggregate (MTA). The patient had local swelling and fistula 7years after trauma in the upper jaw. Periapical lesion on tooth #12 and root resorption of tooth #11 were detected radiographically. Endodontic therapy and placement of intracanal medication were carried out. After 3months, with no improvement in the clinical signs and symptoms, computed tomography was performed, showing extensive apical bone resorption on tooth #12 and dental resorption promoting communication of the root canal with the periodontium of tooth #11. The patient was referred to endodontic surgery. After surgery and postoperative periods of 15, 30, 60, 90, and 120days, standardized radiographs were taken, digitized, and subjected to digital subtraction of the images using Adobe Photoshop CS software. Four years later, a cone-beam computed tomography was performed, showing bone repair and absence of root resorption at tooth #11. In this clinical case, digital subtraction radiography was effective for early detection of new bone formation and evolution of repair. © 2011 John Wiley & Sons A/S.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Ciências Biológicas (Biologia Vegetal) - IBRC

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A neoplasia gástrica é doença heterogênea e multifatorial, com incidência e mortalidade variando geograficamente. Aproximadamente 60% dos diagnósticos em pacientes de países ocidentais ocorrem nos estádios III ou IV. Nestes doentes, o melhor tratamento consiste na realização de procedimento cirúrgico. OBJETIVO: Identificar os aspectos epidemiológicos de pacientes diagnosticados com adenocarcinoma gástrico T4b. MÉTODOS: Estudo observacional, transversal, retrospectivo, de fonte secundária, dos pacientes diagnosticados com adenocarcinoma gástrico T4b através de estadiamento patológico. Foram analisados 815 prontuários, sendo 27 pacientes estudados. As variáveis investigadas foram: aspectos demográficos, principais queixas, fatores de risco, acesso ao serviço de saúde, aspectos cirúrgicos, morbidade, mortalidade e sobrevida. RESULTADOS: Vinte e dois eram homens (81,5%) e cinco mulheres (18,5%) com idade variando de 38 a 87 e média de 58,78 anos. O tempo de acesso ao serviço, em meses, variou de 1 a 120, com média de 12,5. Os sinais e sintomas mais prevalentes foram: perda de peso 23 (85,2%), epigastralgia 22 (81,5%), vômitos 16 (59,3%) e plenitude gástrica 12 (44,4%). A frequência de acometimento das estruturas adjacentes foi: pâncreas oito (29,6%), fígado sete (25,9%), cólon transverso seis (22,2%), intestino delgado seis (22,2%), mesocólon três (11,1%), baço um (3,7%) e vesícula biliar um (3,7%). Morbidades pós-operatórias ocorreram em 51,85% dos pacientes. Houve associação significativa entre mortalidade cirúrgica e ocorrência de fístula/deiscência, choque séptico e sangramento. A sobrevida ao final de seis meses foi de 63,27%. CONCLUSÃO: A média do tempo entre início dos sintomas e acesso ao serviço de saúde especializado foi elevada. Mais da metade dos pacientes apresentaram morbidades pós-operatórias. Os pacientes que apresentaram fístula/deiscência, sangramentos e choque séptico tiveram associação significativa com mortalidade cirúrgica. A sobrevida ao final de seis meses foi de 63,27%.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Herein is reported the case of a patient who presented initially with aortic insufficiency and a fistula between the sinus of Valsalva and right atrium when aged 31 years. Closure of the fistula and replacement of the aortic valve with a Starr-Edwards A-9 caged-ball prosthesis was performed in 1972, since when the valve has survived for 40 years without dysfunction. This is one of the longest follow ups of the Starr-Edwards prosthesis reported, and highlights the possibility of acceptable valve performance over long periods of time.

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A Multi-locus mixed mating model and correlated mating model were used to analyze the mating system of four natural populations of Peltophorum dubium (Sprengel) Taubert from Western Sao Paulo State, Brazil. Open pollinated seeds were collected from 19 to 33 seed-trees per population and evaluated by allozyme electrophoresis analysis. Significant differences between pollen and ovule gene frequencies were detected in more than 50% of loci in each population, indicating deviations from random mating, probably due to correlated mating, self-fertilizations and mating among relatives. The comparison the fixation index estimated from seed trees ((F) over cap (m), ranged from 0.009 to 0.285) with their progenies ((F) over cap (p), ranged from 0.127 to 0.364) suggested selection against inbreeding between offspring of adult stages. The estimates of multi-locus outcrossing rate (t(m)) ranged from 0.557 to 0.924, indicating that the species has a mixed-mating system. Differences between multi-locus and single-locus outcrossing rate (t(m)-t(s))was positive and significantly different from zero for all populations, with values ranging from 0.092 to 0.111, suggesting mating among relatives within the populations, probably due to the presence of intra-population spatial genetic structure. The mean coefficient of co-ancestry (Theta) within progenies ranged from 0.147 to 0.251; confirming that the progenies are compounded by mixtures of different kinds of relatedness. The results are discussed from the view of genetic improvement and conservation of the species.

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Patients submitted to hemodialysis are at a high risk for healthcare-associated infections (HAI). Presently there are scarce data to allow benchmarking of HAI rates in developing countries. Also, most studies focus only on bloodstream infections (BSI) or local access infections (LAI). Our study aimed to provide a wide overview of HAT epidemiology in a hemodialysis unit in southeastern Brazil. We present data from prospective surveillance carried out from March 2010 through May 2012. Rates were compared (mid-p exact test) and temporally analyzed in Shewhart control charts for Poisson distributions. The overall incidence of BSI was 1.12 per 1000 access-days. The rate was higher for patients performing dialysis through central venous catheters (CVC), either temporary (RR = 13.35, 95% CI = 6.68-26.95) or permanent (RR = 2.10,95% CI = 1.09-4.13), as compared to those with arteriovenous fistula. Control charts identified a BSI outbreak caused by Pseudomonas aeruginosa in April 2010. LAI incidence was 3.80 per 1000 access-days. Incidence rates for other HAI (per 1000 patients-day) were as follows: upper respiratory infections, 1.72; pneumonia, 1.35; urinary tract infections, 1.25; skin/soft tissues infections, 0.93. The data point out to the usefulness of applying methods commonly used in hospital-based surveillance for hemodialysis units. (C) 2013 Elsevier Editora Ltda. All rights reserved.

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Pós-graduação em Enfermagem (mestrado profissional) - FMB