Pneumoperitôneo progressivo no pré-operatório de hérnias incisionais volumosas

OBJETIVO: Avaliar o pneumoperitôneo no preparo pré-operatório de pacientes portadores de hérnias incisionais volumosas. MÉTODO: Foram estudados cinco pacientes portadores de hérnias incisionais volumosas, encaminhados ao Serviço de Cirurgia Plástica do Hospital Universitário Clementino Fraga Filho da UFRJ, no período de agosto de 1994 a abril de 1997. Foi efetuado pneumoperitôneo progressivo, complementando a terapêutica pré-operatória instituída nestes pacientes. RESULTADOS: Não houve intercorrências durante os procedimentos de instalação do pneumoperitôneo. Um paciente - o único do sexo masculino - não aceitou bem a expansão intra-abdominal e decidiu interromper o tratamento. As cirurgias se mostraram tecnicamente facilitadas: em três casos foi possível a sutura direta da aponeurose comprometida, sendo necessário o uso de tela de polipropileno em apenas um paciente. O acompanhamento de 15 a 47 meses mostrou boa evolução e ausência de recidivas. CONCLUSÃO: O pneumoperitônio progressivo nos pacientes estudados, portadores de hérnias incisionais volumosas, se mostrou um método simples e eficaz do preparo pré-operatório.

Complicações pós-operatórias em pacientes submetidos à abdominoplastia isolada e combinada à outras cirurgias do abdome

OBJETIVO: A realização de abdominoplastias associadas a outras cirurgias da parede ou da cavidade abdominal, embora atrativa, é motivo de controvérsias. O objetivo deste trabalho é avaliar o grau de morbidade e mortalidade destas associações. MÉTODO: Foram estudados retrospectivamente 75 pacientes com indicação de abdominoplastia dos quais 39 submeteram-se a abdominoplastia isoladamente (grupo 1) e 36 à associação de abdominoplastia a outras cirurgias do abdome (grupo 2), como correção de hérnias, histerectomias e colecistectomias. Foram analisados os diversos fatores capazes de interferir na evolução do paciente, como doenças pré-existentes, assim como as complicações pós-operatórias. RESULTADOS: As complicações observadas foram: seroma (grupo 1: 2.6% , grupo 2: 25%,), epidermólise (grupo 1: 12.82% , grupo 2: 5.55%), deiscência de sutura (grupo 1: 5.12% , grupo 2: 5.55%), infecção da ferida operatória (grupo 1: 0%, grupo 2: 8.33%) e hematoma (grupo 1: 0%, grupo 2: 5.55%). Não houve diferença estatisticamente significante entre os dois grupos no que se refere a complicações pós-operatórias, exceto quanto ao seroma (p=0,009). CONCLUSÕES: Concluímos que não houve aumento significativo da morbidade e da mortalidade dos pacientes submetidos a cirurgias combinadas quando comparados aos pacientes submetidos à abdominoplastia isoladamente.

Voyages en suisse et en Italie

UANL

Antimicrobial resistance of heterotrophic marine bacteria isolated from seawater and sands of recreational beaches with different organic pollution levels in southeastern Brazil: evidences of resistance dissemination

Antimicrobial resistance of marine heterotrophic bacteria to different antimicrobials agents were evaluated in seawater, dry and wet sands from three marine recreational beaches with different pollution levels. In all studied beaches, the greatest frequencies of resistance were found in relation to penicillin. on Gonzaguinha, the most polluted beach, 72.3% of all isolated strains showed simple resistance, whilst 8.33% had multiple resistance. The values found on Ilha Porchat beach, were 70.8% and 6.9% for simple and multiple resistances, respectively. on GuaraA(0), the less polluted beach, only 35.3% of isolated strains had simple resistance. Multiple resistance was not observed. While samples from Gonzaguinha and Ilha Porchat beach showed isolated strains resistant to seven and six different antimicrobial agents, respectively, samples from GuaraA(0) beach were resistant only to penicillin and erytromicin. The positive correlations obtained between the degree of seawater contamination and frequency and variability of bacterial resistance indicate that polluted marine recreational waters and sands are sources of resistant bacteria contributing thus, to the dissemination of bacterial resistance.

Antimicrobial resistance and species composition of Enterococcus spp. isolated from waters and sands of marine recreational beaches in Southeastern Brazil

Density, species composition and antimicrobial resistance in bacteria of the Enterococcus genus were evaluated in seawater and sands from 2 marine recreational beaches with different levels of pollution. The 2 beaches showed predominance of Enterococcus faecalis and Enterococcus faecium, in the water and the sand. Dry sand presented higher densities of Enterococcus sp. and higher frequency of resistant strains than wet sand and seawater. The beach with a higher degree of pollution presented higher percentages of resistant strains (66.7% and 61.5%, in sand and in water, respectively) and resistance to a larger number of antimicrobials compared with the less polluted beach, Ilha Porchat (35.7% and 31.25% of resistant strains in sand and water, respectively). in water samples, the highest frequencies of resistance were obtained against streptomycin (38.5%) and erythromycin (25%), whilst in sand, the highest frequencies were observed in relation to erythromycin and tetracycline (38.1% and 14.3%, respectively). These results show that water and sands from beaches with high indexes of faecal contamination of human origin may be potential sources of contamination by pathogens and contribute to the dissemination of bacterial resistance. (C) 2007 Elsevier Ltd. All rights reserved.

Densidade de Enterococcus sp em águas recreacionais e areias de praias do município de São Vicente-SP, Brasil e sua relação com parâmetros abióticos

Coastal cities attract a large number of tourists for their beautiful landscape and recreational activities, increasing the municipalities' income source. Thus, a need is clear for the establishment of beach quality monitoring programs to ensure bathers health. Although there is an effective monitoring program for recreational waters in Brazil there are no programs to certify the quality of beach sands. In this sense, the aim of this work was to analyze the density of bacteria from the genus Enterococcus in both sand and water from two beaches from São Vicente, São Paulo (Brazil) and correlate these densities to abiotic parameters such as: temperature, salinity, particle size, organic matter and tides). Water and sand samples were collected during February 2006 on the beaches of Gonzaguinha e Ilha Porchat and bacterial densities were determined by membrane filter technique. Temperature and salinity were measured in situ with a thermometer and a refractometer while particle size and organic matter were determined according to methods described by Suguio and Dean. There were significant differences between densities found in water and sand (p=0.004), being approximately 20 times higher in Gonzaguinha's beach sands. Similar results were found for Ilha Porchat beach samples, being the densities found in sand 3 times greater than those found in water. Both beaches showed a negative correlation between bacterial densities and salinity and temperature, suggesting a deleterious effect of these parameters on the bacterial community. On the other hand, no correlation was found between organic matter and particle size and bacterial densities. This work demonstrates that there is a great necessity for monitoring beach sand since the evaluation of beach quality is an important part of integrated coastal management programs.

Population structure of a native and an alien species of snail in an urban area of the Atlantic Rainforest

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

Com quanta tristeza de faz uma depressão

Resenha do livro A tristeza perdida de Allan V. Horwitz e Jerome C. Wakefield - Summus Editorial 2010

Psicanálise, gênero e singularidade

Psychology, and more specifically Psychoanalysis have been called to manifest themselves about current phenomena regarding gender and sexuality issues. The demand for acting on these matters has grown, partly due to the influence of media. It is possible to point out limits on the performance of these professionals for lacking a reflection on the concept of subject, the effects of a pathologization of gender and the use of a binary conception of gender.

Tatuagem, unheimliche e identificação: desvelamentos

The tattoo is a social phenomenon found in all social strata, with broad inclusion in all age groups and their motivation is commonly related to aesthetic pleasure, beauty and interest in body art. These references, however, are insufficient to understand the B side of the experience: the nightmares, attempts to erase, the compulsion and the concern about stop tattooing. Something happens between the search of beauty and the execution of the tattoo, that drags out the person to the anguish dimension. In detailing this, the specificity of distress Unheimliche will serve as our guide and, in the epistemological function of uncovering, allow an approximation to the concept of identification. Reading of the concept, the identification function will appear and, with it, the uncovering of the infinite pulse of desiring, when the object wants to talk,represent itself and manifest.The tattoos psychic function in the neurosis is the same for each step every morning: find the object and with this North, calibrate the compass of neurosis.

A transexualidade hoje:questões para pensar o corpo e o gênero na psicanáise

Esse artigo propõe que a noção de transexualidade seja discutida a partir de vários aspectos que ela implica. O objetivo é problematizar a escuta clínica que poderia se deixar influenciar apenas pelo viés patológico, sem levar em conta o panorama atual em que a transexualidade se insere. Propomos que a transexualidade seja entendida como um conceito guarda-chuva, que abriga diferentes formas de manifestar o gênero e com variado grau de intervenção ou modificação corporal. Abordamos a rigidez dos critérios diagnósticos, a concepção de gênero, a precocidade no tratamento da transexualidade, a influência da mídia e teorizações sobre a origem da transexualidade. Destacamos o sofrimento psíquico imposto pelo campo da saúde ao estabelecer padrões de coerência entre sexo e gênero como sendo da ordem do impossível. Escutar cada pessoa transexual em sua singularidade, sem descartar a cirurgia de redesignação sexual como possível solução, nos parece ser a postura mais adequada ao trabalho psicanalítico.