Laparoscopic antireflux surgery in patients with extra esophageal symptoms related to asthma

Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings. The comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002). Laparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma.Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. W2729295sem informaçãosem informaçã

Finger Burns Caused By Concentrated Hydrofluoric Acid, Treated With Intra-arterial Calcium Gluconate Infusion: Case Report [queimadura Digital Por ácido Fluorídrico Concentrado Tratada Com Infusão Intra-arterial De Gluconato De Cálcio: Relato De Caso]

Context: Hydrofluoric acid (HF) is widely used in industry and at home. Severe lesions can occur after contact with highly concentrated solutions, leading to tissue necrosis and bone destruction. Specific treatment is based on neutralization of fluoride ions with calcium or magnesium solutions. Case report: A 41-year-old male was seen at the emergency department 35 minutes after skin contact with 70% HF, showing whitened swollen lesions on the middle and fourth fingers of his right hand with severe pain starting immediately after contact. 2.5% calcium gluconate ointment was applied. Twenty-four hours later, the patient was still in severe pain and the lesions had worsened. Considering the high concentration of the solution, early start of severe pain, lesion characteristics and impossibility of administering calcium gluconate subcutaneously because of the lesion location, the radial artery was catheterized and 2% calcium gluconate was administered via infusion pump for 36 hours, until the pain subsided. No adverse effects were seen during the procedure. Ten days later, the lesions were stable, without bone abnormalities on X-rays. Six months later, a complete recovery was seen. Conclusions: Intra-arterial calcium gluconate might be considered for finger burns caused by concentrated HF. Complete recovery of wounded fingers can be achieved with this technique even if started 24 hours after the exposure. However, controlled clinical trials are needed to confirm the effectiveness and safety of this intervention.1276379381Anderson, W.J., Anderson, J.R., Hydrofluoric acid burns of the hand: Mechanism of injury and treatment (1988) J Hand Surg Am, 13 (1), pp. 52-57Sheridan, R.L., Ryan, C.M., Quinby Jr., W.C., Blair, J., Tompkins, R.G., Burke, J.F., Emergency management of major hydrofluoric acid exposures (1995) Burns, 21 (1), pp. 62-64Lin, T.M., Tsai, C.C., Lin, S.D., Lai, C.S., Continuous intra-arterial infusion therapy in hydrofluoric acid burns (2000) J Occup Environ Med, 42 (9), pp. 892-897Roblin, I., Urban, M., Flicoteau, D., Martin, C., Pradeau, D., Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate (2006) J Burn Care Res, 27 (6), pp. 889-894Vance, M.V., Curry, S.C., Kunkel, D.B., Ryan, P.J., Ruggeri, S.B., Digital hydrofluoric acid burns: Treatment with intraarterial calcium infusion (1986) Ann Emerg Med, 15 (8), pp. 890-896Graudins, A., Burns, M.J., Aaron, C.K., Regional intravenous infusion of calcium gluconate for hydrofluoric acid burns of the upper extremity (1997) Ann Emerg Med, 30 (5), pp. 604-60

Banco de dados de experimentos para fins de simulação em desenvolvimento de culturas agrícolas.

O artigo descreve a importância de um banco de dados para experimentos agrícolas na Embrapa e no SNPA (Sistema Nacional de Pesquisa Agropecuária) para fins de simulação em crescimento de culturas baseado na estrutura do DSSAT que foi apresentado em palestra nesse Workshop. Aborda-se o assunto na forma de um estudo de caso, onde empregou-se a técnica orientada a objetos (OMT de James Rum baugh) na análise do problema pra facilitar a captura de requisitos junto aos pesquisadores (futuros usuários do sistema). Exemplifica-se o uso da técnica OMT, mostrando-se a sua coerência entre modelos, adequação ao estudo de controle de experimentos e as dificuldades entradas no trabalho

Antibacterial evaluation of Styrax pohlii and isolated compounds

The antibacterial activity of the compounds egonol (1) and homoegonol (2), of the crude ethanolic extract of Styrax pohlii (Styracaceae) aerial parts (EE), and of its n-hexane (HF), EtOAc (EF), n-BuOH (BF), and hydromethanolic (HMF) fractions was evaluated against the following microorganisms: Streptococcus pneumoniae (ATCC 6305), S. pyogenes (ATCC 19615), Haemophilus influenzae (ATCC 10211), Pseudomonas aeruginosa (ATCC 27853), and Klebsiella pneumoniae (ATCC 10031). The broth microdilution method was used for determination of the minimum inhibitory concentration (MIC) during preliminary evaluation of antibacterial activity. The EE yielded MIC values of 400 µg/mL for S. pneumoniae and P. aeruginosa and 300 µg/mL for H. influenzae. The HF and EF fractions exhibited enhanced antibacterial activity, with MIC values of 200 µg/mL against S. pneumoniae, but only EF displayed activity against H. influenzae (MIC 200 µg/mL). The best MIC value with compounds 1 and 2 (400 µg/mL) was obtained for (1) against S. pneumoniae and P. aeruginosa. Therefore, 1 exhibited weak antibacterial activity against these standard strains

Clinical And Laboratory Characterization Of Hypertensive Chagas' Disease Patients Without Evident Heart Failure [caracterização Clínico-laboratorial De Chagásicos Hipertensos Sem Insuficiência Cardíaca Manifesta]

This study evaluated the characteristics of 125 Chagas disease patients aged ≥ 25 years or over who were attended at the Clinical Hospital of the State University of Campinas, State of São Paulo. Arterial pressure, age, gender, skin color, heart disease, body mass index, lipid profile, blood glucose level, alcohol and tobacco dependence, dyslipidemia, diabetes, anxiety disorders and obesity were investigated. It was found that the hypertensive Chagas disease patients were older than the nonhypertensive ones (p = 0.028). Among the hypertensive patients, there were more women (p = 0.015); higher blood glucose, LDL cholesterol and total cholesterol levels (p = 0.005, p = 0.024 and p = 0.017); more diabetics (p = 0.006); and more cardiac damage (p = 0.04) and left ventricular hypertrophy (p = 0.003). Only the age of patients with cardiac damage was shown to be higher (p = 0.003). The hypertensive Chagas disease patients presented clinical and laboratory characteristics that were similar to those of the general hypertensive population. This association may compound the harmful effects on the cardiovascular system.412163168Almeida, E.A., Barbosa Neto, R.M., Guariento, M.E., Wanderley, J.S., Souza, M.L., Apresentação clínica da doença de Chagas crônica em indivíduos idosos. 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(2002) Revista de Saúde Pública, 36, pp. 135-140Costa, M.F.F.L., Barreto, S.M., Guerra, H.L., Firmo, J.O.A., Uchoa, E., Vidigal, P.G., Ageing with Trypanosoma cruzi infection in a community where the transmission has been interrupted: The Bambuí Health and Ageing Study (BHAS) (2001) International Journal of Epidemiology, 30, pp. 887-893Fuchs, F.D., Moreira, L.B., Moraes, R.S., Bredemeier, M., Cardozo, S.C., Prevalência da hipertensão arterial sistêmica e fatores associados na região urbana de Porto Alegre. Estudo de base populacional. (1994) Arquivos Brasileiros de Cardiologia, 63, pp. 473-479Guariento, M.E., Alegre, S.M., Souza, L.R.M.F., Evolução clínica de pacientes chagásicos acompanhados em um serviço de referência. (2002) Revista da Sociedade Brasileira de Medicina Tropical, 35 (SUPL III), pp. 206-207Guariento, M.E., Camilo, M.V.F., Camargo, A.M.A., Working conditions of Chagas' disease patients in a large Brazilian city (1999) Cadernos de Saúde Pública, 15, pp. 381-386Guariento, M.E., Orosz, J.E.B., Gontijo, J.A.R., Interação clínica entre a moléstia de Chagas e hipertensão arterial primária em um serviço de referência ambulatorial. (1998) Arquivos Brasileiros de Cardiologia, 70, pp. 431-434Guariento, M.E., Ramos, M.C., Gontijo, J.A.R., Carvalhal, S.S., Doença de Chagas e hipertensão arterial primária. (1993) Arquivos Brasileiros de Cardiologia, 60, pp. 71-75Guariento ME, Wanderley JS, Almeida EA. Doença de Chagas. In: Lopes AC, Ward LS, Guariento ME (eds) Medicina Ambulatorial. Editora Atheneu, São Paulo, p. 225-236, 2006Gurgel, C.B.F.M., Miguel Jr, A., Mendes, C.R., Zerbini, C.O., Carcioni, T.M., Freqüência da hipertensão arterial na doença de Chagas crônica. Estudo clínico retrospectivo. (2003) Arquivos Brasileiros de Cardiologia, 81, pp. 541-544Gus, I., Fischmann, A., Medina, C., Prevalência dos fatores de risco da doença arterial coronariana no estado do Rio Grande do Sul. (2002) Arquivos Brasileiros de Cardiologia, 78, pp. 478-483Hueb, M.F.D., Loureiro, S.R., Revisão: Aspectos cognitivos e psicossociais associados à doença de Chagas. Psicologia em Estudo (2005), 10, pp. 137-142Ianni, B.M., Mady, C., Artega, E., Fernandes, F., Doenças cardiovasculares observadas durante o seguimento de um grupo de pacientes na forma indeterminada da doença de Chagas. (1998) Arquivos Brasileiros de Cardiologia, 71, pp. 21-24Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.H., Global burden of hypertension: Analysis of worldwide data (2005) Lancet, 365, pp. 217-223Maguire, J.H., Hoff, R., Sherlock, I., Guimaraes, A.C., Sleigh, A.C., Ramos, N.B., Mott, K.E., Weller, T.H., Cardiac morbidity and mortality due to Chagas' disease: Prospective electrocardiographic study of a Brazilian community (1987) Circulation, 75, pp. 1140-1145Oliveira, F., Reis, M.A., Teixeira, P.A., A cardiopatia chagásica em idosos necropsiados. (2001) Revista da Sociedade Brasileira de Medicina Tropical, 34 (SUPL III), pp. 161-162Aspectos clínicos de la enfermedad de Chagas. Informe de una reunión conjunta OMS/OPAS de investigadores. Organización Mundial de la Salud (1974) Boletín de la Oficina Sanitaria Panamericana, 76, pp. 141-158. , Organización Panamericana de la SaludPorto, C.C., O eletrocardiograma no prognóstico e evolução da doença de Chagas (1964) Arquivos Brasileiros de Cardiologia, 17, pp. 313-346Rassi N. Diabetes tipo 2. In: Porto CC, Porto AL (eds) Vademecum de Clínica Médica. Editora Guanabara Koogan, 2a edição, Rio de Janeiro, p. 251-253, 2007Sarno, F., Monteiro, C.A., Importância relativa do índice de massa corporal e da circunferência abdominal na predição da hipertensão arterial. (2007) Revista de Saúde Pública, 41, pp. 788-796Silveira AC. O Controle da Doença de Chagas nos Países do Cone Sul da América: História de uma iniciativa internacional 1991-2001. In: Silveira AC (org) O Controle da Doença de Chagas nos Países do Cone Sul da América: História de uma iniciativa internacional 1991-2001. Organização Pan-Americana da Saúde, Brasília, p. 15-43, 2002(2001) Prevenção de Aterosclerose-Dislipidemia, pp. 1-18. , Sociedade Brasileira de Cardiologia, Projeto Diretrizes da Associação Médica Brasileira e Conselho Federal de Medicina, pIV Diretrizes Brasileiras de Hipertensão Arterial. (2004) Arquivos Brasileiros de Cardiologia, 82 (SUPL 4), pp. 1-14. , Sociedade Brasileira de Cardiologia(2006) Sociedade Brasileira de Hipertensão Arterial e Sociedade Brasileira de Nefrologia. V Diretrizes Brasileiras de Hipertensão Arterial, p. 6. , Sociedade Brasileira de Cardiologia, São Paulo, p(2006) Atualização Brasileira sobre Diabetes, Diagraphic, pp. 3-14. , Sociedade Brasileira de Diabetes, Rio de Janeiro, p(2004) Diabetes Mellitus: Classificação e Diagnóstico, pp. 1-8. , Sociedade Brasileira de Endocrinologia e Metabologia, Projeto Diretrizes da Associação Médica Brasileira e Conselho Federal de Medicina, p(2004) Sobrepeso e Obesidade: Diagnóstico, pp. 1-9. , Sociedade Brasileira de Endocrinologia e Metabologia, Projeto Diretrizes da Associação Médica Brasileira e Conselho Federal de Medicina, pStaessen, J.A., Wang, J., Bianchi, G., Birkenhager, W.H., Essential hypertension (2003) Lancet, 361, pp. 1629-1641Trindade, I.S., Heineck, G., Machado, J.R., Ayzemberg, H., Formighieri, M., Crestani, M., Gusso, J., Prevalência da hipertensão arterial sistêmica na população urbana de Passo Fundo (RS). (1998) Arquivos Brasileiros de Cardiologia, 71, pp. 127-130Zaitune, M.P.A., Barros, M.B.A., César, C.L.G., Carandina, L., Goldbaum, M., Hipertensão arterial em idosos: Prevalência, fatores associados e práticas de controle no município de Campinas, São Paulo, Brasil. (2006) Cadernos de Saúde Pública, 22, pp. 285-29