Repositório RCAAP
Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure
CONTEXT: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research. OBJECTIVE: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea) and also the relevance of the vocal folds closure in this process. METHODS: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed. The respiratory air flux interruptions produced by wet requested swallows and dry, requested and spontaneous swallows, were registered using thermo and piezoelectric receptors coupled to synectics medical manometry equipment, using Polygram upper 4.21 software. The results were analyzed with the Chi-square (3×2) and (2×2) nonparametric independency test with P = 0.05. RESULTS: Swallowing apnea is a preventive breathing stop that start just before and stay present during all deglutition pharyngeal phase. It is a well coordinated phenomena that occur as pattern in association with low elastic resistance of the lung, on the expiratory final phase until inspiration initial phase. This breathing stoppage it is usually followed by a short expiraton preceding a new breathing cycle. The swallow apnea and vocal folds closure are both independents mechanisms. CONCLUSION: It is possible to suppose that in the subconscious condition, swallowing apnea is integrated under coordination of the same control mechanism that also involves the elastic resistance of the lung.
2010
Costa,Milton Melciades Barbosa Lemme,Eponina Maria de Oliveira
Nutritional follow-up of patients with ulcerative colitis during periods of intestinal inflammatory activity and remission
CONTEXT: Ulcerative colitis is an inflammatory bowel disease involving superficial inflammation of the mucosa of the colon, rectum, and anus, sometimes including the terminal ileum. When in clinical activity, the disease is characterized by various daily evacuations containing blood, mucus and/or pus alternating periods of remission. OBJECTIVE: To compare nutritional parameters (dietary, biochemical and anthropometric) among patients with ulcerative colitis followed up on an outpatient basis over a period of 1 year and during periods of intestinal inflammatory activity and remission. METHODS: Sixty-five patients were studied over a period of 1 year and divided into two groups: group 1 with inflammatory disease activity (n = 24), and group 2 without disease activity (n = 41). Anthropometric measures, biochemical parameters, quantitative food intake, and qualitative food frequency were analyzed. RESULTS: A significant reduction in body mass index and weight and in the intake of energy, proteins, lipids, calcium, iron and phosphorus was observed in the group with inflammatory activity (group 1) when compared to the period of clinical remission. The most affected food groups were cereals, legumes, oils, and fats. In contrast, in group 2 significant differences in triceps and sub scapular skin fold thickness, total protein, hemoglobin and hematocrit were observed between the first and final visit. Calcium and vitamin B6 intake, as well as the consumption of legumes, meat and eggs, and sugar and sweets, was significantly higher than on the first visit. CONCLUSION: Patients with ulcerative colitis followed up on an outpatient basis tend to be well nourished. However, the nutritional aspects studied tend to worsen during the period of inflammatory disease activity.
2010
Ripoli,Juliana Miszputen,Sender Jankiel Ambrogini Jr,Orlando Carvalho,Luciana de
Discordância de apresentação da doença celíaca em gêmeos monozigóticos
CONTEXTO: A doença celíaca é uma enteropatia autoimune causada pela sensibilidade ao glúten em indivíduos geneticamente predispostos. Apesar da característica genética da doença, estudos demonstram discordância de 30% na sua apresentação em gêmeos monozigóticos. OBJETIVO: Apresentar dois pares de gêmeos monozigóticos, comprovados por estudos genéticos, discordantes para apresentação da doença celíaca. MÉTODO: Os pacientes foram acompanhados no Serviço de Gastroenterologia Pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais desde 1990, sendo submetidos a exames clínicos periódicos, biopsias intestinais e sorologia para anticorpos IgG e IgA antigliadina, determinados pela técnica de ELISA (ensaio imunoenzimático), e anticorpos classe IgA antiendomísio, determinados pela técnica de imunofluorescência indireta. Estudos genéticos foram realizados através da técnica de amplificação por PCR e posterior tipagem de loci de microssatélites do tipo STR (short tandem repeats). RESULTADOS: Em cada par de gêmeos, apenas um apresentou doença celíaca até o momento, mostrando que, apesar do genótipo idêntico, este não foi o único determinante para a expressão da doença. CONCLUSÃO: Outros fatores, ambientais e genéticos, parecem contribuir para determinação da doença.
2010
Bahia,Magda Penna,Francisco José Castillo,Dora Mendez Del Hassegawa,Marina Guimarães Corrê Vieira,Aline Cristina Orlando,Vanessa Ribeiro
Serological screening for celiac disease in symptomatic 12 to 36 month-old children
CONTEXT: The correct diagnosis of celiac disease in environmentally deprived children is frequently hindered by the common presence of other causes for the classical celiac disease symptoms: malnutrition, failure to thrive and frequent diarrheas. OBJECTIVES: To determine the prevalence of celiac disease in a group of 12 to 36 month-old children using immunoglobulin antibodies against gliadin (IgG and IgA-AGA), against endomysium (IgA-EMA), and against human tissue transglutaminase (IgA-tTG) as screening method. METHODS: A total of 214 children (114 boys), aged 12 to 36 months, on gluten-containing diet, were admitted to the study. IgG and IgA-AGA, IgA-tTG and IgA-EMA tests were performed in all sera. Biopsy was obtained from all children showing positive result in one or more of the serologic tests, excluding those in which IgG-AGA had been the only positive result. In those cases, polymerase chain reaction (PCR) HLA genotyping for the identification of celiac disease predisposing alleles was applied. HLA genotyping was also performed to confirm the diagnosis in children identified as celiac by means of positive serologic testing and compatible biopsy results. RESULTS: Normal results were obtained in 131 children. Ten children out of 68 identified as positive exclusively on the IgG-AGA test disclosed the presence of celiac disease predisposing alleles on PCR and underwent jejunal biopsy with normal results. All serologic tests were positive in four children. A fifth child showed positive IgG and IgA-AGA and IgA-tTG results but disclosed a negative IgA-EMA test. Jejunal biopsy of these five children revealed characteristic lesions of celiac disease. CONCLUSION: A prevalence of 2.3% was found among symptomatic 12- to 36-month-old children that had not been previously diagnosed as celiac.
2010
Modelli,Inês Cristina Gandolfi,Lenora Almeida,Rodrigo Coutinho de Araújo,Gloria Maria A. C Picanço,Marilúcia de Almeida Pratesi,Riccardo
Clinical features and prevalence of gastroesophageal reflux disease in infants attending a pediatric gastroenterology reference service
CONTEXT: In infants, it is not always easy to distinguish between pathological and physiological gastroesophageal reflux based only on clinical criteria. In Brazil, studies about gastroesophageal reflux disease in infants are few and are even rare those that used prolonged esophageal pH monitoring for its evaluation. OBJECTIVE: To describe the clinical features of gastroesophageal reflux disease and to determine its prevalence in infants with gastroesophageal reflux attending a tertiary Pediatric Gastroenterology Service and submitted to esophageal pH monitoring for investigation. METHODS: Descriptive study in 307 infants in whom esophageal pH monitoring (Mark III Digitrapper, Synectics Medical AB, Sweden) was performed during the period December, 1998-December, 2008. The clinical features studied were age group (1-12 months and 13-24 months), and clinical manifestations that motivated the indication of pH monitoring. RESULTS: One hundred twenty-four (40.4%) were female and 183 (59.6%) male with mean age 12.2 ± 6.2 months (1-23 months). The prevalence of gastroesophageal reflux disease was 18.2% (56/307). One hundred forty-eight (48.2%) were 1-12 months old and 159 (51.8%), 13-24 months. No significant difference was found between the prevalence of these two age groups (P = 0.3006). Gastroesophageal reflux disease was more frequent in those with digestive manifestations (24.2%), crisis of cyanosis/apnea (23.8%) and mixed manifestations (21.5%). Respiratory manifestations were the most frequent indication (39.1%) of pH monitoring. However, the prevalence of gastroesophageal reflux disease was lower (12.5%) in this group compared with in those with digestive manifestations (P = 0.0574), crisis of cyanosis/apnea (P = 0.0882) and mixed manifestations (P = 0.1377). All infants that presented clinical manifestations as crisis of cyanosis/apnea and abnormal pH-metry were < 3 months of age. CONCLUSIONS: In our Service, the prevalence of gastroesophageal reflux disease associated with acid reflux in infants revealed elevated. Infants with crisis of cyanosis/apnea constitute risk population for gastroesophageal reflux disease in which diagnostic investigation needs to be considered.
2010
Koda,Yu Kar Ling Ozaki,Marcos J Murasca,Kelly Vidolin,Eliana
Melatonin protects the liver and erythrocytes against oxidative stress in cirrhotic rats
CONTEXT: Cirrhosis is a progressive chronic hepatopathy which constitutes an irreversible stage of liver dysfunction. OBJECTIVES: To evaluate the oxidative stress in the blood of cirrhotic rats treated with the antioxidant melatonin. METHODS: Cirrhosis was induced through inhalation of carbon tetrachloride. Liver integrity was evaluated by measuring serum enzymes, oxidative damage measured by lipoperoxidation, and antioxidant enzyme activity in erythrocytes. Lipoperoxidation, total nitrates, collagen, and histology by picrosirius staining were evaluated in the livers of these animals (n = 15), which were divided in three groups: control, carbon tetrachloride, and carbon tetrachloride + melatonin. Melatonin (20 mg/kg) was administered intraperitoneal from week 10 of carbon tetrachloride inhalation. In order to shorten the cirrhosis induction time, phenobarbital (0.3 g/L) was added to the animals' drinking water. RESULTS: A significant impairment in the liver integrity of melatonin-treated animals as compared to cirrhotic animals was observed. In rat erythrocytes and liver, lipoperoxidation was significantly increased in the cirrhotic rats as compared to controls, as measured through thiobarbituric acid reactive substances, and significantly decreased in melatonin-treated animals as compared to cirrhotic ones. In blood, a decrease in superoxide dismutase and glutathione peroxidase enzymes was detected in the cirrhotic group as compared to the control group, with increased superoxide dismutase activity when melatonin was administered. A reduction in the levels of total nitrates was detected in the hepatic tissue of the animals in the carbon tetrachloride group as compared to the control group and an increase of these levels in the carbon tetrachloride + melatonin group. As for hepatic collagen, we found a significant increase in the carbon tetrachloride group as compared to the controls and a regression of these values in the treated group. In histology, the rats in the carbon tetrachloride group showed fibrosis and formation of fibrotic nodules, characterizing liver cirrhosis; there was reduction of nodules and fibrosis in the melatonin treated group. CONCLUSION: The data allow us to suggest that the observed oxidative stress is related to the damages caused by carbon tetrachloride and that the use of melatonin can minimize these damages
2010
Rosa,Darlan Pase da Bona,Silvia Simonetto,Douglas Zettler,Claudio Marroni,Cláudio Augusto Marroni,Norma Possa
Hepatotrophic factors reduce hepatic fibrosis in rats
CONTEXT: Hepatic fibrosis occurs in response to several aggressive agents and is a predisposing factor in cirrhosis. Hepatotrophic factors were shown to stimulate liver growth and to restore the histological architecture of the liver. They also cause an improvement in liver function and accelerate the reversion of fibrosis before it progresses to cirrhosis. OBJECTIVE: To test the effects of hepatic fibrosis solution composed by amino acids, vitamins, glucose, insulin, glucagon and triiodothyronine on hepatic fibrosis in rats. METHODS: Fibrosis was induced in rats by gastric administration of dimethylnitrosamine (10 mg/kg) for 5 weeks. After liver biopsy, the rats received either hepatotrophic factors solution (40 mg/kg/day) or saline solution for 10 days by intraperitoneal injection. Blood samples and liver fragments were collected for hepatic function analysis, standard histopathology evaluation, and morphometric collagen quantification. RESULTS: Rats in the hepatotrophic factors group showed a decrease of the histopathological components of fibrosis and an increase of their hepatic mass (12.2%). There was no development of neoplasic lesions in both groups. Compared with the saline group, the hepatotrophic factors group also had a decrease of blood levels of hepatic-lesion markers (AST, ALT) and a decrease of collagen content in the portal spaces (31.6%) and perisinusoidal spaces (42.3%), as well as around the hepatic terminal vein (57.7%). Thus, hepatotrophic factors administration in the portal blood promoted a regenerative hepatic response, with an overall reduction of the volumetric density of collagen, improved hepatic function, and a general improvement in the histopathological aspects of fibrosis. CONCLUSION: Taken together, these results suggest the potential therapeutic use of this hepatotrophic factors solution to treat chronic liver diseases.
2010
Cogliati,Bruno Pereira,Hélder de Moraes Dagli,Maria Lúcia Zaidan Parra,Osório Miguel Silva,José Roberto Machado Cunha da Hernandez-Blazquez,Francisco Javier
The vitamin E reduces liver lipoperoxidation and fibrosis in a model of nonalcoholic steatohepatitis
CONTEXT: No effective treatment is available for nonalcoholic steatohepatitis in nowadays. OBJECTIVES: To develop a model of nonalcoholic steatohepatitis induced by a methionine and choline deficient diet, as well as to evaluate the role of metformin, vitamin E and simvastatin in the nonalcoholic steatohepatitis progression. METHODS: The study analyzed prospectively 50 Wistar rats for a 90-day period and divided them into five groups of 10 rats. One group was given standard rat diet and the others received the methionine and choline deficient diet. Among the four groups that received this diet, one received saline 0,9% and the others received metformin, vitamin E or simvastatin. After the study period, the animals were sacrificed and their blood was collected for biochemical analysis. The livers were removed for lipoperoxidation analysis and for the histological examinations. RESULTS: The methionine and choline deficient diet was able to induce steatosis in 100% of the animals and nonalcoholic steatohepatitis in 27 (69.2%). The alanine aminotransferase levels were significantly higher in the simvastatin group. The aspartate aminotransferase levels were also higher in the simvastatin group, but were statistically significant only in relation to the standard diet group. When lipoperoxidation values were compared, the groups that received standard rat diet and methionine and choline deficient with vitamin E presented significantly lower rates than the others. The presence of fibrosis was significantly smaller in the group receiving vitamin E. CONCLUSIONS: The diet used was able to induce steatosis and nonalcoholic steatohepatitis. Besides vitamin E showed to reduce the liver oxidative stress, as well as the fibrosis development
2010
Zamin Jr,Idilio Mattos,Angelo Alves de Mattos,Ângelo Zambam de Coral,Gabriela Santos,Diogo Rhoden,Cláudia
Probióticos e prebióticos na atenção primária ao câncer de cólon
CONTEXTO: As neoplasias de cólon são a terceira forma mais comum de câncer atualmente. Seus tratamentos ainda estão associados a elevado risco de complicações, ressaltando, assim, a necessidade de elaborar novas estratégias de tratamento. A ingestão de probióticos, prebióticos ou a combinação de ambos (simbióticos), representa nova opção terapêutica. Diante da importância do equilíbrio quantitativo e qualitativo da microbiota intestinal para saúde humana e com objetivo de melhor elucidar o papel dos probióticos e prebióticos, o tema citado procura abordar a importância destes como coadjuvantes na prevenção e tratamento de câncer de cólon. METODOLOGIA: Foi realizada pesquisa em bancos de dados científicos (Medline, Lilacs, PubMed, Ovid, Scielo) através de levantamento de artigos científicos, além da busca direta aos periódicos, priorizando-se os mesmos do período de 2003 a 2008. Foram, também, coletadas informações através de sites da internet, como forma de melhor compreender a epidemiologia, conceitos e tratamentos dessa patologia. RESULTADOS: Estudos apontam relação inversa entre o consumo de probióticos e prebióticos e o diagnóstico de câncer de cólon, sendo que alguns dos possíveis mecanismos englobam: aumento da resposta imune, redução da resposta inflamatória, inibição de formação de células tumorais e da conversão de substâncias pré-carcinogênicas em carcinogênicas. CONCLUSÃO: Através da realização desta revisão literária foi possível obter respostas positivas quanto ao uso de probióticos e prebióticos na carcinogênese, colocando seu uso como recomendado de forma adequada.
2010
Denipote,Fabiana Gouveia Trindade,Erasmo Benício Santos de Moraes Burini,Roberto Carlos
Guidelines for the diagnosis and management of gastroesophageal reflux disease: an evidence-based consensus
Gastroesophageal reflux disease (GERD) is one of the most common disorders in medical practice. A number of guidelines and recommendations for the diagnosis and management of GERD have been published in different countries, but a Brazilian accepted directive by the standards of evidence-based medicine is still lacking. As such, the aim of the Brazilian GERD Consensus Group was to develop guidelines for the diagnosis and management of GERD, strictly using evidence-based medicine methodology that could be clinically used by primary care physicians and specialists and would encompass the needs of physicians, investigators, insurance and regulatory bodies. A total of 30 questions were proposed. Systematic literature reviews, which defined inclusion and/or exclusion criteria, were conducted to identify and grade the available evidence to support each statement. A total of 11,069 papers on GERD were selected, of which 6,474 addressed the diagnosis and 4,595, therapeutics. Regarding diagnosis, 51 met the requirements for the analysis of evidence-based medicine: 19 of them were classified as grade A and 32 as grade B. As for therapeutics, 158 met the evidence-based medicine criteria; 89 were classified as grade A and 69 as grade B. In the topic Diagnosis, answers supported by publications grade A and B were accepted. In the topic Treatment only publications grade A were accepted: answers supported by publications grade B were submitted to the voting by the Consensus Group. The present publication presents the most representative studies that responded to the proposed questions, followed by pertinent comments. Follow examples. In patients with atypical manifestations, the conventional esophageal pH-metry contributes little to the diagnosis of GERD. The sensitivity, however, increases with the use of double-channel pH-metry. In patients with atypical manifestations, the impedance-pHmetry substantially contributes to the diagnosis of GERD. The examination, however, is costly and scarcely available in our country. The evaluation of the histological signs of esophagitis increases the diagnostic probability of GERD; hence, the observation of the dimensions of the intercellular space of the esophageal mucosa increases the probability of diagnostic certainty and also allows the analysis of the therapeutic response. There is no difference in the clinical response to the treatment with PPI in two separate daily doses when compared to a single daily dose. In the long term (>1 year), the eradication of H. pylori in patients with GERD does not decrease the presence of symptoms or the high recurrence rates of the disease, although it decreases the histological signs of gastric inflammation. It seems very likely that there is no association between the eradication of the H. pylori and the manifestations of GERD. The presence of a hiatal hernia requires larger doses of proton-pump inhibitor for the clinical treatment. The presence of permanent migration from the esophagogastric junction and the hernia dimensions (>2 cm) are factors of worse prognosis in GERD. In this case, hiatal hernias associated to GERD, especially the fixed ones and larger than 2 cm, must be considered for surgical treatment. The outcomes of the laparoscopic fundoplication are adequate.
2010
Moraes-Filho,Joaquim Prado P. Navarro-Rodriguez,Tomas Barbuti,Ricardo Eisig,Jaime Chinzon,Decio Bernardo,Wanderley
Early marginal ulcer following Roux-en-Y gastric bypass under proton pump inhibitor treatment: prospective multicentric study
CONTEXT: Causal factors of gastrojejunal ulcers after Roux-en-Y gastric bypass include peptic acid secretion from the gastric pouch. Esomeprazole is a potent inhibitor of acid secretion. OBJECTIVE: To assess the occurrence of dyspepsia and gastrojejunal ulcers within the first 2 months after Roux-en-Y gastric bypass during the use of esomeprazole. METHODS: One hundred eighteen morbid obese subjects were submitted to Roux-en-Y gastric bypass. Preoperative upper gastrointestinal tract endoscopy was negative for H. pylori. All subjects received esomeprazole for 60 days after surgery. RESULTS: Two weeks after surgery only 13 mild symptoms were reported. After 2 months, 17 also moderate complaints were registered. Endoscopy around the 60th day showed esophagitis in 10 (8.5%), hiatal hernia in 2 (1.7%), foreign body in the anastomotic line in 12 (10.2%) and gastrojejunal ulcers was observed in 9 (7.6%) subjects, 2 of which had a suture material or metallic staple granuloma in the gastrojejunostomy. Ten subjects took nonsteroidal anti-inflammatory drugs at least once during study, but none of them developed ulcer. None of the subjects with ulcer had dyspeptic symptoms. CONCLUSION: The incidence of ulcer in the gastrojejunal anastomosis within the first 2 months following Rouxen-Y gastric bypass under proton pump inhibitors is considerable. It was not related to the use of non-steroidal anti-inflammatory drugs, highlighting the possibility of ischemia and foreign body as causal factors. The ulcers were asymptomatic, and all post-surgical dyspeptic symptoms were moderate in severity.
2010
Garrido Jr.,Arthur Belarmino Rossi,Marçal Lima Jr.,Sizenando Ernesto Brenner,Antonio Sérgio Gomes Jr,Claudio Antonio Rufino
Surgical treatment of cystic neoplasms of the pancreas
CONTEXT: Diagnosis and treatment of cystic neoplasms of the pancreas increased significantly in the last decades. There are only a few Brazilian publications on these tumors. The majority of them are limited to reports of one or few cases. OBJECTIVE: To present our experience with 27 patients with cystic neoplasms of the pancreas. METHODS: Demographic data, clinical manifestations, diagnostic exams, surgical procedures, postoperative complications, and follow-up data of 27 patients with cystic neoplasms of the pancreas were analyzed, according to the histological type of the tumor. RESULTS: There were 10 (37%) serous cystic tumors, 10 (37%) mucinous cystic tumors, 4 (15%) intraductal papillary mucinous tumors, and 3 (11%) solid pseudopapillary tumors or Frantz tumor. All serous cystic tumors, 6 (60%) mucinous tumors, 2 (50%) intraductal papillary mucinous tumors, and 2 (67%) solid pseudopapillary tumors were benign. The age of the patients varied from 31 to 82 years and all tumors were more common in female. Two patients had been treated previously as a pseudocyst. Surgical procedures depended on the location and extension of the tumor. Two patients underwent only laparotomy with tumor biopsy, one cholecystectomy with Roux-en-Y hepaticojejunostomy for jaundice treatment, 6 pancreatoduodenectomy, and 18 partial pancreatectomy. The most common postoperative complication was pancreatic fistula (n = 5; 19%). One patient died of necrotic pancreatitis. Of the 10 patients with serous cystic tumor, only 1 had tumor recurrence at the section border. The three patients with mucinous cystoadenocarcinoma in which was not possible to resect the tumor, died 6 to 24 months after laparotomy. The six patients with benign mucinous tumors did not have tumor recurrence. CONCLUSIONS: The most common cystic neoplasms of the pancreas are serous and mucinous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 40% of mucinous cysts are malign. Misdiagnosis may delay appropriate treatment and increase mortality.
2010
Coelho,Júlio Cezar Uili Valle,Christian Lopez Ribas,Bruno Moraes Andriguetto,Leonardo Dudeque Claus,Christiano Marlo Paggi
Analysis of the immunohistochemical expressions of p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and their correlations with the prognostic factors
CONTEXT: Search of tumors markers that allow treatment with higher survival rates, and indicate the response to treatment and recurrence of cancer OBJECTIVE: To analyze the immunoexpression of the proteins p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and correlate them with the clinical-pathological prognostic factors. METHOD: Tissue microarray paraffin blocks were made from colorectal adenocarcinoma tissue resected from 82 patients who had undergone surgery but not chemotherapy or radiotherapy, at "Hospital São Paulo", São Paulo, SP, Brazil, between 2002 and 2005. Thin sections (4 µm) were subjected to immunohistochemical reactions, and immunoexpression staining scores were obtained. The scores were correlated with the degree of cell differentiation, staging, disease-free interval, recurrence, survival and specific mortality. The study variables were analyzed using the chi-square and Kaplan-Meier tests to investigate associations with the markers. The significance of the differences between the curves of the disease-free interval and survival was analyzed using the Logrank and Wilcoxon tests. RESULTS: The immunohistochemical expression of p53 was positive in 70 tumors (85.4%) and negative in 12 (14.6%). The expression of bcl-2 was positive in 26 (31.7%) and negative in 56 (68.3%). The expression of Ki-67 was positive in 62 (75.6%) and negative in 20 (24.4%). There was no statistically significant correlation between the expressions of these markers separately or in conjunction, in relation to the degree of cell differentiation, staging, disease-free interval, survival and specific mortality. In relation to recurrence, there was a statistically significant correlation with positive expression of Ki-67 (P = 0.035). CONCLUSION: The immunohistochemical expression of Ki-67 in colorectal cancer is associated with recurrence of this disease.
2010
Menezes,Hunaldo Lima de Jucá,Mário Jorge Gomes,Edmundo Guilherme de A. Nunes,Benício L. Bulhões B. P. Costa,Henrique Oliveira Matos,Delcio
Analysis of the videolaparoscopy potentiality in the surgical treatment of the bowel obstruction
CONTEXT: Laparotomy is the gold standard treatment of patients with intestinal obstruction without response to clinical management. Nowadays, literature has been demonstrating the feasibility of videolaparoscopy in the treatment of intestinal obstruction. OBJECTIVES: To report the clinical-epidemiological profile of patients with intestinal obstruction submitted to surgery and verify the presence of contraindications for laparoscopy. METHODS: It was done a observational, descriptive and retrospective study including adults patients with intestinal obstruction submitted to surgery at Hospital de Clínicas de Porto Alegre, RS, Brazil, between January of 2004 and October of 2008. RESULTS: It was included 135 patients in the study, with a total of 126 patients submitted to open surgery and 9 to laparoscopy. There was similar distribution between gender and the mean age was 59 years (SD ± 16.9). The most frequent site of obstruction was the small bowel and the most frequent etiology was adhesions. Among the patients submitted to laparotomy, 75.4% presented with abdominal distention, 68.3% previous abdominal surgery, 11.9% body mass index >30 kg/m², 4.8% coagulopathy and 3.2% hemodynamic instability. Among the 135 patients, only 5 of them presented with none contraindications for videolaparoscopy. CONCLUSION: The epidemiological findings of this study are similar to the ones of the worldwide literature. Indications of videolaparoscopy in retrospective analyses have the limitation of subjective evaluation of intestinal obstruction, which was included in this study as a relative contraindication to laparoscopy.
2010
Ghezzi,Tiago Leal Moschetti,Laura Corleta,Oly Campos Abreu,Gabriela Pilau de Abreu,Laís Pilau de
Influência de diferentes cultivos e fatores climáticos na ocorrência de crisopídeos em sistema agroecológico
Os insetos predadores da família Chrysopidae têm sido relatados tanto em ecossistemas naturais como nos agroecossistemas, sejam eles cultivos consorciados ou monocultivos. Porém, são escassas as informações sobre o comportamento das populações desses insetos nos agroecossistemas diversificados, como aqueles de base agroecológica. O presente trabalho teve o objetivo de determinar a riqueza de espécies de crisopídeos e avaliar a influência de diferentes cultivos agrícolas, assim como de fatores climáticos na abundância desses insetos em sistema de produção orgânica diversificada. O estudo foi conduzido de setembro de 2008 a agosto de 2009, por meio de amostragens semanais de adultos de Chrysopidae em áreas do Sistema Integrado de Produção Agroecológica, em Seropédica (RJ), cada qual com um tipo de sistema de cultivo (rotação milho-mucuna/olerícolas, cafeeiros sombreados e rotação cana-de-açúcar/pastagem de braquiária). Um total de 424 espécimes de crisopídeos foi coletado, sendo distribuídos em três espécies: Chrysoperla externa (98,1%), Ceraeochrysa cubana (1,7%) e Ceraeochrysa paraguaria (0,2%). Não houve diferença no número de adultos coletados em função dos diferentes cultivos, embora a análise de correlação evidencie que as rotações com poáceas favoreçam o aumento da sua abundância. A abundância dos crisopídeos foi influenciada pelo clima apenas no sistema de cafeeiros sombreados, sendo correlacionada negativamente com a temperatura média do ar e a com a precipitação pluvial acumulada.
2014
Resende,André Luis Santos Souza,Brígida Aguiar-Menezes,Elen de Lima Oliveira,Rafael José Campos,Maria Emilia Souzalima
Consumo foliar da traça-das-crucíferas em couve e brócolis tratados com sinigrina
A estimativa da área foliar, em função da sua redução causada pelo consumo por insetos filófagos, é uma metodologia básica em várias áreas da Entomologia, como, por exemplo, em estudos sobre resistência de plantas, entomologia econômica e ecologia nutricional. Um dos fatores que pode interferir na quantidade de área foliar consumida pelo fitófago é a presença de certos químicos nas folhas, como a sinigrina em brassicáceas. Dessa forma, foram aplicadas em folhas de couve e brócolis diversas concentrações de sinigrina (0,2, 0,4, 0,8, 1,6, e 3,2 mg/mL em solução a 5% de Tween20(r)), medindo-se o consumo da área foliar por lagartas de P. xylostella, o qual foi aferido pela porcentagem de redução da área, diferença de peso e escala visual de notas. Os resultados mostraram que as concentrações 0,2, 0,4 e 3,2 mg/mL de sinigrina aumentam o consumo em folhas de couve e diminuem em folhas de brócolis por lagartas de P. xylostella. As metodologias utilizadas proporcionam resultados similares, sendo as estimativas de peso fresco e nota visual mais práticas.
2014
Bortoli,Sergio Antonio De Carvalho,Jackeline da Silva Vacari,Alessandra Marieli Goulart,Roberto Marchi
Composição mineral de substratos à base de resíduos de bananeira durante o cultivo de Pleurotus ostreatus
O objetivo deste trabalho foi avaliar a composição mineral (macro e micronutrientes) dos substratos [(inicial e residual (pós-colheita)] à base de diferentes combinações de resíduos (folha, pseudocaule e pseudocaule + folha) e cultivares de bananeira - Musa spp. (Thap Maeo, Prata Anã, Pelipita e Caipira), durante 49 dias de cultivo da linhagem POS 09/100 de Pleurotus ostreatus. Verificaram-se que todos os substratos à base de resíduos de diferentes cultivares de bananeira apresentaram quantidades satisfatórias de nutrientes para o cultivo de P. ostreatus, tanto na fase inicial de cultivo como na final.
2014
Carvalho,Cristiane Suely Melo de Sales-Campos,Ceci Aguiar,Lorena Vieira Bentolila de Minhoni,Marli Teixeira de Almeida Andrade,Meire Cristina Nogueira de
Avaliação microbiológica de carne de charque produzida industrialmente
O charque é um produto cárneo salgado e seco ao Sol obtido por desidratação da carne bovina, preservando-se, assim, por longo tempo. Apesar de passar por etapas que dificultam o crescimento de micro-organismos, pode ser contaminado durante o seu processamento. Dessa forma, objetivou-se avaliar microbiologicamente 25 amostras de charque de um frigorífico com serviço de inspeção estadual localizado no Rio Grande do Norte, Brasil. As amostras foram avaliadas quanto à contagem de estafilococos coagulase positiva, NMP de coliformes termotolerantes, Salmonellaspp. e contagem de bactérias halofílicas. Avaliando a qualidade microbiológica da carne de charque, verificaram-se que cinco amostras (20%) encontravam-se em desacordo com a legislação vigente (ANVISA) para análises de estafilococos coagulase positiva, apresentando uma variação de 1,38 a 3,93 UFC/g; todas as amostras estavam em conformidade para coliformes termotolerantes. Quanto à determinação da Salmonellaspp., verificou-se sua presença em sete amostras (28%), e para bactérias halofílicas, uma média de 2,25 UFC/g. Assim, as carnes de charque apresentaram micro-organismos que comprometem a qualidade do produto e podem proporcionar risco ao consumidor.
2014
Abrantes,Maria Rociene Sousa,Ana Carina Praciano Araújo,Nikolay Kiev Saraiva de Sousa,Êlika Suzianny de Oliveira,Adriene Rosceli Menezes de Silva,Jean Berg Alves da
Resposta de cultivares de Brachiaria brizantha a doses de biofertilizantes de aves
Cada vez mais fertilizantes são importados, fato que faz com que o uso de dejetos tratados seja alternativa econômica e sustentável para a produção de forragens. O objetivo do trabalho foi avaliar o efeito da aplicação de diferentes doses de biofertilizante de aves sobre a produção de forragem de cultivares de Brachiaria brizantha(Hochst.) Stapf. O delineamento experimental utilizado foi o inteiramente casualizado, com quatro repetições, em esquema fatorial. O primeiro fator consistiu nos cultivares Marandu e Piatã de B. brizantha, enquanto o segundo fator correspondeu às doses de biofertilizante de aves (0, 50, 100 e 150 m3 ha-1). Foram avaliados os seguintes caracteres morfométricos: altura de planta (AP), comprimento da lâmina foliar (CLF), largura da lâmina foliar (LLF) aos 15, 30, 45 e 60 dias após a emergência (DAE), e massa de matéria verde e seca (MV e MS, respectivamente) das folhas, colmo e raízes aos 60 DAE. A dose de 50 m3 ha-1de biofertilizante de aves promoveu incrementos nas características morfométricas e produção de forragem dos cultivares Marandu e Piatã, enquanto doses de 100 e 150 m3 ha-1 ocasionaram a morte desses cultivares.
2014
Silva,Patrícia Paiva da Ferreira,Rafael Silva Teodoro,Paulo Eduardo Torres,Francisco Eduardo Arima,Gilcelene Medeiros Cappi,Nanci Ribeiro,Larissa Pereira
Zoonoses parasitárias veiculadas por alimentos de origem animal: revisão sobre a situação no Brasil
O Brasil se destaca na produção mundial de alimentos de origem animal, sendo que cada vez mais os mercados consumidores buscam alimentos seguros e inócuos para a saúde. Nesse contexto, torna-se fundamental a prevenção das zoonoses, que podem ser transmitidas através dos alimentos de origem animal, que muitas vezes são consumidos sem o devido preparo ou por populações mais vulneráveis. Nesta revisão bibliográfica, serão abordadas importantes enfermidades parasitárias de caráter zoonótico que ocorrem atualmente pela via de transmissão alimentar: a toxoplasmose, o complexo teníase-cisticercose, criptosporidiose, anisacose, difilobotriose e triquinelose.
2014
Rossi,Gabriel Augusto Marques Hoppe,Estevam Guilherme Lux Martins,Ana Maria Centola Vidal Prata,Luiz Francisco