Laparoscopic nephrectomy outside gerota fascia for management of inflammatory kidney

Background and Purpose: A nonfunctioning inflammatory kidney is a challenging surgical condition for urologists. Some investigators recommend open surgery because of the surgical difficulties caused by the inflammatory process, whereas others try to apply the advantages of a ""simple"" non-hand-assisted laparoscopic approach. We report our experience with simple laparoscopic nephrectomy for inflammatory kidney management. Patients and Methods: From July 2002 through December 2006, 50 pure laparoscopic nephrectomies were performed for inflammatory kidney ( 43 because of pyelonephritis, 5 for xanthogranulomatous pyelonephritis (XGP), and 2 for pyonephrosis). Histopathologic analysis was the criterion used for inflammatory kidney diagnosis. Pain or recurrent urinary tract infection associated with a nonfunctioning excluded kidney was the eligibility criterion for the procedure. Preoperatively, all patients underwent complete image and functional renal assessment. Morcellation was used to remove surgical specimens. Conversion index, surgical difficulties, operative time, and postoperative complications were evaluated. Results: Conversion was performed in 14 of 50 (28%) patients, including two with XGP and one with pyonephrosis. Adhesions, vascular (two inferior vena cava) lesions, and intestinal lesions (two colon) were the main causes of conversion. Acute pancreatitis developed in one patient, and one patient had a wound infection. Reoperations were unnecessary, and no deaths occurred. Conclusion: Pure laparoscopic nephrectomy was successful in 72% of patients with inflammatory kidneys. The laparoscopic dissection was useful even in those cases converted to open surgery. This is a high-risk procedure, however, and both surgeon and patient must be aware of that before the decision is made for this approach.

Bioacumulação de metais pesados e nutrientes no mexilhão dourado do reservatório da Usina Hidrelétrica de Itaipu Binacional

This study aims to evaluate the bioaccumulation of macronutrients and heavy metals in the golden mussel according to its collection site and seasonality in the aquaculture area of the reservoir from April/2009 to March/2010. There is no difference (p > 0.05) in the concentration of metals with respect to the point of collection. The concentrations of Cu, Fe, Mn, Zn, Cd and Pb were higher (p < 0.05) in spring and summer than in fall and winter. Values of the heavy-metal pollution index (MPI) for collection point and seasonality indicate environmental contamination in the aquaculture area.

Leiomiossarcoma de Mama: Relato de caso

Relatamos um caso de neoplasia maligna de mama com diagnóstico de leiomiossarcoma. Esta rara neoplasia tem comportamento biológico menos agressivo que outros tipos de sarcomas; por isso, chamamos atenção para o correto diagnóstico e a necessidade de graduação do neoplasma para seguimento da paciente, que, em nosso caso, com 2 anos de seguimento apresenta-se sem recidiva da doença.

Polymorphism in CYP17, GSTM1 and the progesterone receptor genes and its relationship with mammographic density

Radiologic breast density is one of the predictive factors for breast cancer and the extent of the density is directly related to postmenopause. However, some patients have dense breasts even during postmenopause. This condition may be explained by the genes that codify for the proteins involved in the biosynthesis, as well as the activity and metabolism of steroid hormones. They are polymorphic, which could explain the variations of individual hormones and, consequently, breast density. The constant need to find markers that may assist in the primary prevention of breast cancer as well as in selecting high risk patients motived this study. We determined the influence of genetic polymorphism of CYP17 (cytochrome P450c17, the gene involved in steroid hormone biosynthesis), GSTM1 (glutathione S-transferase M1, an enzyme involved in estrogen metabolism) and PROGINS (progesterone receptor), for association with high breast density. One hundred and twenty-three postmenopausal patients who were not on hormone therapy and had no clinical or mammographic breast alterations were included in the present study. The results of this study reveal that there was no association between dense breasts and CYP17 or GSTM1. There was a trend, which was not statistically significant (P = 0.084), towards the association between PROGINS polymorphism and dense breasts. However, multivariate logistic regression showed that wild-type PROGINS and mutated CYP17, taken together, resulted in a 4.87 times higher chance of having dense breasts (P = 0.030). In conclusion, in the present study, we were able to identify an association among polymorphisms, involved in estradiol biosyntheses as well as progesterone response, and radiological mammary density.

Estudio prospectivo de la demanda social de puestos escolares en los centros universitarios del Distrito Universitario de Valencia.

Conocer la demanda de puestos escolares en la universidad y el orden preferencial con que son elegidos. Conocer condicionantes psicológicos académicos y sociológicos de los alumnos a la hora de la elección de carrera para una mejor orientación. Ofrecer información sobre la formación superior. Así como las posibilidades de trabajo que se ofrecen a cada una de las titulaciones. 9150 alumnos de COU en el Distrito Universitario de Valencia, curso 1981-82; 4029 varones y 5121 mujeres. Un 65,87 por ciento de la población de COU en Valencia. Se pasó una encuesta que pide información sobre variables socio-académicas; status socio-económico de la familia, nivel cultural de la misma, preferencias académicas, profesionales y sobre la orientación psicopedagógica que los alumnos hayan podido recibir antes de comenzar sus estudios. Hace un análisis cruzado entre las variables socio-educativas, estudios preferidos y profesión futura. Previamente al pase del cuestionario en las aulas, se formaron unos equipos de profesores de las facultades que fueron por los distintos centros impartiendo unas charlas sobre orientación universitaria. Intención de seguir estudiando en un 95,2 de los casos. Mayor inclinación por estudios científicos. La mitad de los alumnos no ha tenido nunca ningún tipo de orientación psico-pedagógica. Los alumnos procedentes de las clases baja y media baja escogen como profesión futura: profesor de EGB y carreras cortas. Los aspirantes a alumnos de carreras de letras o leyes, han obtenido mejores notas en materias humanísticas; otro tanto sucede con los aspirantes a estudiar en Escuelas Técnicas o Facultades de Ciencias, en materias de Ciencias. La influencia de los padres se da sobre todo en las clases alta y media-alta. La influencia personal es determinante en las elecciones. Padres, amigos y profesores, contribuyen poderosamente. La mayoría de los alumnos eligen carrera porque creen tener aptitudes para ella, aunque existen grupos diferenciados. La fácil colocación es el ítem con más bajo índice de respuestas. Al alumno de COU no le preocupa excesivamente su futuro profesional, sino que está concienciado de que debe continuar sus estudios universitarios por imperativos de su formación y de las expectativas sociales.

Subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum in a renal transplant patient

A 49-year-old renally transplanted man, under a five-year course of immunosuppressive therapy with prednisone and cyclosporine A, experienced a subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum. The clinical presentation consisted of impressive, large, inflammatory and draining cystic tumors on the left foot that had been present for one year. A significant improvement was obtained with itraconazole plus intralesional injection with amphotericin B. Drug interaction was observed between itraconazole and cyclosporine A causing a severe hypertensive crisis and requiring a temporary sharp reduction in cyclosporine administration. Subcutaneous phaeohyphomycosis caused by P. parasiticum is uncommon among major organ transplant patients but several cases have previously been published and some patterns are emerging, e. g., limbs are generally involved but no known traumatic event has preceded lesion development. The identification of the case isolate was confirmed using a recently published online system based in part on beta-tubulin sequence comparison.

Characterisation of the chromosome fusions in Oreochromis karongae

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

Experimental model for transanal endorectal pull-through surgery. Technique of de la Torre and Ortega

Background: We describe an experimental model for transanal endorectal pull-through surgery using the method of de]a Torre and Ortega that can be used for training purposes in experimental laboratories.Methods: Ten rabbits were submitted to the transanal endorectal pull-through technique of de la Torre and Ortega. Animals were randomly selected in the Botucatu School of Medicine experimental laboratory. Animals weighted between 2800 and 4400 g. Colons were not prepared, and antibiotic therapy was not used; dipyrone(1) was administered postoperatively for analgesic purposes. We standardized resected segment size, recorded surgical time, and observed Survival and possible complications for 1 month.Results: All animals survived the initial follow-up period without infection. Bowel movements returned quickly, and all animals were evacuating regularly within the first 24 hours. Mean surgical time was 48.6 minutes.Conclusions: the experimental model proposed in this study is very useful for training and improving surgical techniques using the method of de la Torre and Ortega. The rabbit is an excellent animal for this surgery because of its size and postoperative resistance. (c) 2005 Elsevier B.V. All rights reserved.

Substituição do milho pela glicerina em suplementos múltiplos para novilhos Nelore em pastejo

The objective was to evaluate the performance and production costs of Nellore steers growing on Brachiaria brizantha cv. Marandu during the dry season receiving mineral supplements with partial replacement of corn by residual glycerin. 40 Nellore steers with initial body weight of 203.12 +/- 20.10 kg and average initial age of 12 months, distributed into eight paddocks of 1.6 ha each, were used. The experimental design was completely randomized with five replicates and eight supplements. Supplements with levels of partial replacement of corn by glycerin were evaluated: 0% (G0), 10% (G10), 20% (G20), 30% (G30), 40% (G40), 50% (G50) and 60% (G60) provided on the amount of 1 kg/animal/day in the natural matter, and a mineral supplement (MS). The average daily gain (ADG) was higher (P<0.05) in animals receiving supplements G30 (0.609 kg), G40 (0.588 kg) and G60 (0.611 kg) in relation to supplements G0 (0.546 kg), G10 (0.509 kg), G50 (0.561 kg) and MS (0.223 kg). There were differences (P <0.10) in ADG in supplemented animals when compared to MS. The supplemented animals showed higher ADG (P<0.05) compared to MS. The different levels provided positive financial return. It is concluded that the supply of multiple supplements replacing the corn by glycerol in production systems of steers in the dry period provides higher productive performance levels of 30, 40 and 60% and positive financial return to levels of 60% of replacement, demonstrating thus, its potential use for intensive systems of beef production on pasture.

Short-term prophylaxis with ciprofloxacin in extended 16-core prostate biopsy

Objective: To evaluate the safety, efficacy and possible complications of 16-core transrectal prostate biopsies using two doses of ciprofloxacin for prophylaxis of infectious complications.Materials and Methods: Sixteen-core prostate biopsies were performed on a number of patients with different signs of potential prostate cancer. Complications were assessed both during the procedure and one week later. After the procedure, urine samples were collected for culture. The rate of post-biopsy complications, hospital visits and hospitalizations were also analyzed. Ciprofloxacin (500 mg) was administered two hours before, and eight hours after the procedure.Results: The overall rate of post-biopsy complications was 87.32%, being 5.4% of those considered major complications due to hemorrhage, or to urinary retention. Eight patients required hospital treatment post-biopsy. Fever occurred in just one patient (0.29%). There was no incidence of orchitis, epididymitis, prostatitis, septicemia, hospitalization, or death. The urine culture showed positive results in five patients (2.15%).Conclusion: One-day prophylaxis with ciprofloxacin proved to be safe and effective in the prevention of infectious complications following 16-core prostate biopsies.